NPIMap

Individual provider Active NPI

Fred M. Caldwell, M.D.

  • Internal Medicine Physician
  • Poplar Bluff, MO
National Provider Identifier
1558308239
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36656 Issued in MO
Practice address
225 Physicians Park Ste 400
Poplar Bluff, MO 63901-3923
Phone
(573) 727-5500
Fax
(573) 727-5599
NPI assigned
Jun 1, 2006
Last updated
Jan 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36656 MO Primary

Addresses

Primary practice location

225 Physicians Park Ste 400
Poplar Bluff, MO 63901-3923

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

Other identifiers 1

IdentifierTypeStateIssuer
202642906MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081111000018 MO Practitioner - Internal Medicine 6800706987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Missouri, Columbia School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians
Internal Medicine Associates of Southeast Missouri LLCGroup PAC ID 5991615072, 43 clinicians

Practice addresses (Care Compare)

1212 Saint Francis Dr
Dexter, MO 63841-2769
Phone (573) 614-3600

150 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049

211 Saint Francis Dr
Cape Girardeau, MO 63703-8399

225 Physicians Park
Suite 400
Poplar Bluff, MO 63901-3923
Phone (573) 727-5500

225 Physicians Park Dr
Suite 400
Poplar Bluff, MO 63901-3923

24 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

3100 Oak Grove Rd
Poplar Bluff, MO 63901-1573
Phone (573) 785-7721

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center Current Accepting new patients
Saint Francis Medical Center CurrentSince Jul 1, 2016 Accepting new patients
Saint Francis Medical Center CurrentSince Jul 1, 2016 Accepting new patients
N & R of Poplar Bluff, Inc. Past Accepting new patients
Ferguson Medical Group Rural Health Center Inc. Past Accepting new patients
Aspire Senior Living Malden, LLC Past Accepting new patients
Rock Point Nursing Center LLC Past Accepting new patients
Winchester Nursing Center, Inc Past Accepting new patients
Aspire Senior Living Poplar Bluff, LLC Past Accepting new patients
Palladian Senior Care of Poplar Bluff LLC. Past Accepting new patients
Helia Healthcare of Poplar Bluff, LLC Past Accepting new patients
Internal Medicine Associates of Southeast Missouri LLC PastSince Mar 30, 2009 Accepting new patients
Poplar Bluff Regional Medical Center LLC Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Puxico 1 Inc Past Accepting new patients

Locations

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

1212 Saint Francis Dr
Dexter, MO 63841
Phone (573) 614-3600

2210 Barron Rd
Poplar Bluff, MO 63901
Phone (573) 686-4133

225 Physicians Park
Ste 400
Poplar Bluff, MO 63901
Phone (573) 785-7721

Interoperability endpoints

  • Direct secure messaging: mcaldwell14175@surescripts.sfmc.net
  • Direct secure messaging: michael.caldwell@cernerdirect.coxhealth.com

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Puxico Nursing & Rehabilitation CenterPuxico, MO, CCN 265496 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 19, 2024
May 19, 2024
Winchester Nursing Center, IncBernie, MO, CCN 265874 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2024
Oct 1, 2024
Rock Point Nursing CenterBirch Tree, MO, CCN 265368 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 1, 2022
Dec 1, 2022
Aspire Senior Living Poplar BluffPoplar Bluff, MO, CCN 265450 Skilled nursing facility Operational/Managerial Control
Managing Control - Governing Body
Adp of the SNF		 May 1, 2024
May 1, 2024
Jul 14, 2025

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1558308239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 PHYSICIANS PARK STE 400",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013923",
            "telephone_number": "573-727-5500",
            "fax_number": "573-727-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "FRED",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "36656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202642906",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.