Individual provider Active NPI

Ernest Bobby Kleier Jr., MD

  • Surgery Physician
  • Waverly, TN
National Provider Identifier
1609934728
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
9046 Issued in TN
Practice address
209 West Main Street
Waverly, TN 37185-1510
Phone
(931) 296-9830
Fax
(931) 296-7350
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Tennessee, HSC, College of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madison Medical Center Stockhoff Memorial Nursing Home 22 clinicians

Practice addresses (Care Compare)

611 W Main St
Fredericktown, MO 63645-1111
Phone (573) 783-3341

Hospital & facility affiliations

  • Madison Medical Center Hospital, Fredericktown, MO, CCN 261302

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: Yes
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20130404000332 MO Practitioner - General SurgeryPractitioner - General Practice 0749278794 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDR3L21MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas County Memorial Hospital CurrentSince Aug 1, 2020 Accepting new patients
Texas County Memorial Hospital CurrentSince Aug 1, 2020 Accepting new patients
Madison Medical Center Stockhoff Memorial Nursing Home CurrentSince Oct 5, 2013 Accepting new patients
Madison Medical Center Stockhoff Memorial Nursing Home CurrentSince Oct 5, 2013 Accepting new patients
Humphreys County Community Health Services, Inc. Past Accepting new patients
Madison Medical Center Stockhoff Memorial Nursing Home Past Accepting new patients

Locations

611 W Main St
Fredericktown, MO 63645
Phone (573) 773-7061

1333 S Sam Houston Blvd
Houston, MO 65483
Phone (417) 967-3311

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 9046 TN Primary
Surgery Physician 208600000X MDR3L21 MO

Addresses

NPPES NPI Registry

Primary practice location

209 West Main Street
Waverly, TN 37185-1510

Mailing address

209 West Main Street
Waverly, TN 37185-1510
Phone (931) 296-9830

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
4027561OtherTNBCBS SURGERY
3183707MedicaidTN
4080719OtherTNBCBS PRIMARY CARE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609934728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 WEST MAIN STREET",
            "city": "WAVERLY",
            "state": "TN",
            "postal_code": "371851510",
            "telephone_number": "931-296-9830",
            "fax_number": "931-296-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 WEST MAIN STREET",
            "city": "WAVERLY",
            "state": "TN",
            "postal_code": "371851510",
            "telephone_number": "931-296-9830",
            "fax_number": "931-296-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIER",
        "first_name": "ERNEST",
        "middle_name": "BOBBY",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "9046",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "MDR3L21",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS SURGERY",
            "identifier": "4027561",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3183707",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PRIMARY CARE",
            "identifier": "4080719",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, TN

Sources for this page

Verify at the official NPI Registry.