NPIMap

Individual provider Active NPI

Brian L Smith, DO

  • Family Medicine Physician
  • Neosho, MO
National Provider Identifier
1619926250
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2001008549 Issued in MO
Practice address
2550 Lusk Dr
Neosho, MO 64850
Phone
(417) 451-2060
Fax
(417) 451-6214
NPI assigned
May 10, 2006
Last updated
Jun 11, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2001008549 MO Primary

Addresses

Primary practice location

2550 Lusk Dr
Neosho, MO 64850

Mailing address

2550 Lusk Dr
Neosho, MO 64850-8855
Phone (417) 451-2060

Other identifiers 1

IdentifierTypeStateIssuer
245312202MedicaidMO

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
I20050912000498 MO Practitioner - Family Practice 9133152176 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians
Mercy Hospital JoplinGroup PAC ID 8820139587, shared by 2 NPIs, 2 clinicians

Practice addresses (Care Compare)

1717 S Range Line Rd B
Mercy Convenient Care
Joplin, MO 64804-3224
Phone (417) 623-2207

2550 Lusk Dr
Neosho, MO 64850-8855
Phone (417) 451-2060

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2001008549MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Joplin CurrentSince Jul 1, 2018 Accepting new patients
Mercy Clinic Joplin LLC Family Medicine CurrentSince Mar 4, 2020 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Jun 6, 2020 Accepting new patients
Mercy Hospital Joplin CurrentSince Jul 1, 2018 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Jun 6, 2020 Accepting new patients

Locations

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

1717 S Range Line Rd
Ste B
Joplin, MO 64804
Phone (417) 556-2231

2550 Lusk Dr
Neosho, MO 64850
Phone (417) 451-2060

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Interoperability endpoints

  • Direct secure messaging: brian.smith@cernerdirect.coxhealth.com
  • Direct secure messaging: bsmith986461@directc.mercy.net

Organizations & group practices 5

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1619926250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 LUSK DR",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648508855",
            "telephone_number": "417-451-2060",
            "fax_number": "417-451-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 LUSK DR",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "64850",
            "telephone_number": "417-451-2060",
            "fax_number": "417-451-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRIAN",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2001008549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "245312202",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neosho, MO

Sources for this page

Verify at the official NPI Registry.