Active NPI
John R. Carlile, MD
- Pediatric Critical Care Medicine Physician
- Springfield, MO
National Provider Identifier
1558309898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 14730
- Practice address
- 1000 E. Primrose
#200
Springfield, MO 65807-5388 - Phone
- (417) 269-1010
- Fax
- (417) 269-6755
- NPI assigned
- Jun 2, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | R8242 | MO | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | 14730 | NV | Primary |
Addresses
Primary practice location
1000 E. Primrose
#200
Springfield, MO 65807-5388
Mailing address
PO Box 4046
Springfield, MO 65808-4046
Phone (417) 269-1010
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 196616 | Other | MO | BLUE SHIELD |
| 701434 | Other | MO | HEALTHLINK |
| 100199150 A | Medicaid | OK | |
| 196616 | Other | MO | BLUE CHOICE |
| 202969408 | 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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372636800000",
"number": "1558309898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4046",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658084046",
"telephone_number": "417-269-1010",
"fax_number": "417-269-6755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E. PRIMROSE",
"address_2": "#200",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658075388",
"telephone_number": "417-269-1010",
"fax_number": "417-269-6755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLILE",
"first_name": "JOHN",
"middle_name": "R.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2013-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "MO",
"license": "R8242",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "NV",
"license": "14730",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "196616",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "701434",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100199150 A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "196616",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202969408",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.