Active NPI
Phillip W Pitney, MD
- Family Medicine Physician
- Louisiana, MO
National Provider Identifier
1528068574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34602
- Practice address
- 211 S 3Rd St
Louisiana, MO 63353-2000 - Phone
- (573) 754-5555
- Fax
- (573) 754-4077
- NPI assigned
- Jul 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34602 | MO | Primary |
Addresses
Primary practice location
211 S 3Rd St
Louisiana, MO 63353-2000
Mailing address
211 S 3Rd St
Louisiana, MO 63353-2000
Phone (573) 754-5555
Other practice location 1
8 Town Center Dr
Bowling Green, MO 63334-2803
Phone (573) 324-2241
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200558906 | Medicaid | MO | |
| 200558948 | Medicaid | MO |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pike Emergency Medicine LLC | Past | Accepting new patients |
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.
-
- Emergency Medicine Physician
- Louisiana, MO
- NPI 1871738823
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551916800000",
"number": "1528068574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 S 3RD ST",
"city": "LOUISIANA",
"state": "MO",
"postal_code": "633532000",
"telephone_number": "573-754-5555",
"fax_number": "573-754-4077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 S 3RD ST",
"city": "LOUISIANA",
"state": "MO",
"postal_code": "633532000",
"telephone_number": "573-754-5555",
"fax_number": "573-754-4077"
}
],
"practiceLocations": [
{
"address_1": "8 Town Center Dr",
"address_purpose": "LOCATION",
"city": "Bowling Green",
"state": "MO",
"postal_code": "633342803",
"country_code": "US",
"telephone_number": "573-324-2241",
"fax_number": "573-324-9864",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PITNEY",
"first_name": "PHILLIP",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-29",
"last_updated": "2019-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "34602",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200558906",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200558948",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisiana, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.