Active NPI
Joseph William Stafford Jr.
- Rural Health Clinic/Center
- West Plains, MO
National Provider Identifier
1528064102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Practice address
- 312 N Kentucky Ave
West Plains, MO 65775-2073 - Phone
- (417) 257-7076
- Fax
- (417) 257-1417
- NPI assigned
- Jun 28, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | R3F13 | MO | |
| Rural Health Clinic/Center | 261QR1300X | Primary |
Addresses
Primary practice location
312 N Kentucky Ave
West Plains, MO 65775-2073
Mailing address
312 N Kentucky Ave
West Plains, MO 65775-2073
Phone (417) 257-7076
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202169405 | Medicaid | MO |
Other names 1
- Bill Stafford
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R3F13 | MO | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
Interoperability endpoints
- bill.stafford.1@17372.direct.athenahealth.com
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346889600000",
"number": "1528064102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 N KENTUCKY AVE",
"city": "WEST PLAINS",
"state": "MO",
"postal_code": "657752073",
"telephone_number": "417-257-7076",
"fax_number": "417-257-1417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 N KENTUCKY AVE",
"city": "WEST PLAINS",
"state": "MO",
"postal_code": "657752073",
"telephone_number": "417-257-7076",
"fax_number": "417-257-1417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAFFORD",
"first_name": "JOSEPH",
"middle_name": "WILLIAM",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-28",
"last_updated": "2012-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "MO",
"license": "R3F13",
"primary": false
},
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202169405",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BILL",
"last_name": "STAFFORD",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in West Plains, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.