Peter R Marcellus, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R3E69 Issued in MO

Practice address

1150 State Highway 248
Ste, 202
Branson, MO 65616-3758

Phone

(417) 335-7000

NPI assigned

Jun 19, 2006

Last updated

Sep 12, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Skaggs Community Hospital Association

  dba Skaggs Center for Internal Medicine

  • Internal Medicine Physician
  • Branson, MO
  • NPI 1083947626
  Authorized official Same address or phone
• Skaggs Community Hospital Association

  dba Skaggs Roark Valley Family Medicine

  • Family Medicine Physician
  • Branson, MO
  • NPI 1134355563
  Authorized official Same address or phone

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1629013966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 STATE HIGHWAY 248",
            "address_2": "STE, 202",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656163758",
            "telephone_number": "417-335-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 STATE HIGHWAY 248",
            "address_2": "STE, 202",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656163758",
            "telephone_number": "417-335-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELLUS",
        "first_name": "PETER",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R3E69",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080110697",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COX HEALTH SYSTEMS",
            "identifier": "1667",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "1107752",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202071965",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8068",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00237019",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hervey Mac Madden, M.D.
• J Bradley Mahan, RPH
• Richard S Makuch, MD
• Robbie Thomas Mangalasseril, M.D.
• Phyllis Johnna Manna, PA-C
• Ryan Michael Marlett
• Marshall Spinal Care, PC
• Matthew Marshall, FNP
• Matthew R Marshall
• Kelly Marti, PA

• Family Medicine Physician in Branson, MO
• Providers in Branson, 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 Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.