Gregory Stanley Zolkowski, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

101186 Issued in MO

Practice address

910 E San Martin St
Bolivar, MO 65613-2893

Phone

(417) 777-4749

Fax

(417) 777-8041

NPI assigned

Nov 18, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

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.

Enrollment records 1

Specialty

Family Practice

Education

Midwestern University, Chicago College of Osteopathic Med, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Potosi Emergency Group, LLCGroup PAC ID 0648588541, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Washington County Memorial Hospital Hospital, Potosi, MO, CCN 261308

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Cost

100

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/f62890b5-77ff-44bd-a981-0a0981047b35/
• Direct secure messaging: gregory.zolkowski@cernerdirect.coxhealth.com

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.

• Potosi Emergency Group, LLC

  • Emergency Medicine Physician
  • Potosi, MO
  • NPI 1881075349
  Medicare reassignment Care Compare group NPD
• Hermann Area Hospital District

  dba Hermann Area District Hospital

  • Family Medicine Physician
  • Hermann, MO
  • NPI 1083749188
  Medicare reassignment NPD
• Sikeston Emergency Group LLC

  • Emergency Medicine Physician
  • Sikeston, MO
  • NPI 1427575299
  Medicare reassignment NPD
• Hermann Area Hospital District

  dba Hermann Area District Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Hermann, MO
  • NPI 1679648661
  NPD
• Cavero Medical Group LLC

  • Internal Medicine Physician
  • Springfield, MO
  • NPI 1528294634
  NPD (past)
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Family Medicine

  NPD (past)
• Washington County Memorial Hospital

  • Critical Access Hospital
  • Potosi, MO
  • NPI 1194838821
  NPD (past)

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

• Washington County Memorial Hospital

  • Critical Access Hospital
  • Potosi, MO
  • NPI 1194838821
  Care Compare affiliation

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1619959145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 536",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656130536",
            "telephone_number": "417-777-4749",
            "fax_number": "417-777-8041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 E SAN MARTIN ST",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656132893",
            "telephone_number": "417-777-4749",
            "fax_number": "417-777-8041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 N Division St",
            "address_purpose": "LOCATION",
            "city": "Blytheville",
            "state": "AR",
            "postal_code": "723151448",
            "country_code": "US",
            "telephone_number": "870-838-7300",
            "fax_number": "870-838-7459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "611 W Lee Ave",
            "address_purpose": "LOCATION",
            "city": "Osceola",
            "state": "AR",
            "postal_code": "723703001",
            "country_code": "US",
            "telephone_number": "870-563-7000",
            "fax_number": "870-563-7189",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1008 N Main St",
            "address_purpose": "LOCATION",
            "city": "Sikeston",
            "state": "MO",
            "postal_code": "638015044",
            "country_code": "US",
            "telephone_number": "573-471-1600",
            "fax_number": "573-472-7606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZOLKOWSKI",
        "first_name": "GREGORY",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-11776",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-11776",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "101186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619959145",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "244710802",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00786258",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenorey Rene Wood, LMSW
• Creighton Woolsey, DPM
• Shelly L Yamnitz, SLP
• Kimberly Ann Youngsma
• Lacey L Zanzie, NP

• Family Medicine Physician in Bolivar, MO
• Providers in Bolivar, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.