Phool Iqbal

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2025026547 Issued in MO

Practice address

1100 N Kentucky Ave
West Plains, MO 65775-2029

Phone

(417) 256-9111

NPI assigned

Jul 25, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Missouri Delta Medical CenterGroup PAC ID 1355252891, 134 clinicians

Ozarks Medical CenterGroup PAC ID 3870491863, 166 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Missouri Delta Medical Center Hospital, Sikeston, MO, CCN 260113
• Ozarks Healthcare Hospital, West Plains, MO, CCN 260078

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Missouri Delta Medical Center

  • Internal Medicine Physician
  • Sikeston, MO
  • NPI 1508967860

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Missouri Delta Medical Center

  • Community/Retail Pharmacy
  • Malden, MO
  • NPI 1578371621
  NPD
• Ozarks Medical Center

  • Psychiatric Hospital Unit
  • West Plains, MO
  • NPI 1235929027
  NPD
• Missouri Delta Medical Center

  • General Acute Care Hospital
  • Sikeston, MO
  • NPI 1831269539
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Missouri Delta Medical Center

  • General Acute Care Hospital
  • Sikeston, MO
  • NPI 1831269539
  Care Compare affiliation
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1457086381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE FL 15",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297494",
            "telephone_number": "212-423-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N KENTUCKY AVE",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752029",
            "telephone_number": "417-256-9111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 E 100th St Apt 1W",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296227",
            "country_code": "US",
            "telephone_number": "929-406-4494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IQBAL",
        "first_name": "PHOOL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-25",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2025026547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iihs Inc.
• William N Iliff
• Independent in-Home Services
• Sara Ingersoll, RD
• Tiffany Iott
• Brian Lee Israel, MD
• Sathish Kumar Itikyala, M.D.
• Brittany Jackson, LPN
• Christy Lynn Jackson, LPC
• Tara Naomi Jackson, DO

• Internal Medicine Physician in West Plains, MO
• Providers in West Plains, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.