Individual provider Active NPI

Randolf J Dunn, NP

  • Family Nurse Practitioner
  • Neosho, MO
National Provider Identifier
1508384363
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017031227 Issued in MO
Practice address
113 W Hickory St
Neosho, MO 64850-1705
Phone
(417) 451-1234
NPI assigned
Aug 31, 2017
Last updated
Jun 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2017031227 MO Primary

Addresses

Primary practice location

113 W Hickory St
Neosho, MO 64850-1705

Mailing address

PO Box 3810
Joplin, MO 64803-3810
Phone (417) 347-8400

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171005003563 MO Practitioner - Nurse Practitioner 7315212040 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeman-Oak Hill Health SystemGroup PAC ID 8325942253, 385 clinicians
Freeman Neosho HospitalGroup PAC ID 4284624552, shared by 6 NPIs, 43 clinicians

Practice addresses (Care Compare)

1102 W 32 St
Joplin, MO 64804-3503
Phone (417) 347-1111

113 W Hickory St
Neosho, MO 64850-1705
Phone (417) 451-1234

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.37 of 100Reported as group
Quality
60.15
Promoting interoperability
100
Improvement activities
40
Cost
77.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2017031227MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Freeman Neosho Hospital CurrentSince Jun 2, 2024 Accepting new patients
Freeman Neosho Hospital CurrentSince Jan 1, 2026 Accepting new patients
Freeman-Oak Hill Health System CurrentSince Apr 27, 2021 Accepting new patients
Freeman Neosho Hospital CurrentSince Jun 2, 2024 Accepting new patients
Freeman-Oak Hill Health System CurrentSince Apr 27, 2021 Accepting new patients

Locations

1002 McIntosh Cir
Ste 6
Joplin, MO 64804
Phone (417) 347-8055

1102 W 32nd St
Joplin, MO 64804
Phone (417) 347-1078

113 W Hickory St
Neosho, MO 64850
Phone (417) 347-1078

336 S Jefferson St
Neosho, MO 64850
Phone (417) 451-4200

Organizations & group practices 5

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

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1508384363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648033810",
            "telephone_number": "417-347-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W HICKORY ST",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648501705",
            "telephone_number": "417-451-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNN",
        "first_name": "RANDOLF",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-31",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017031227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neosho, MO

Sources for this page

Verify at the official NPI Registry.