NPIMap

Individual provider Active NPI

Paul Stephen Stortz, MD

  • Family Medicine Physician
  • Bolivar, MO
National Provider Identifier
1629268016
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2007033587 Issued in MO
Practice address
1120 S Springfield Ave
Bolivar, MO 65613-2512
Phone
(417) 326-7814
Fax
(417) 326-4059
NPI assigned
Jul 31, 2007
Last updated
Jul 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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 2007033587 MO Primary

Addresses

Primary practice location

1120 S Springfield Ave
Bolivar, MO 65613-2512

Mailing address

1120 S Springfield Ave
Bolivar, MO 65613-2512
Phone (417) 326-7814

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
I20090511000006 MO Practitioner - Family Practice 8628126307 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizens Memorial HealthcareGroup PAC ID 4183528169, 144 clinicians

Practice addresses (Care Compare)

Bolivar, MO 65613
Phone (417) 328-6631

1125 N Butterfield Rd
CMH Dermatology
Bolivar, MO 65613-1056
Phone (417) 328-4500

1155 W Parkview
Bolivar, MO 65613-7800

1155 W Parkview
2K CMH Rheumatology
Bolivar, MO 65613-8598
Phone (417) 328-7000

1155 W Parkview St
Bolivar, MO 65613-7800

1155 W Parkview St
Bolivar, MO 65613-8597

1155 W Parkview St
1C
Bolivar, MO 65613-8279
Phone (417) 326-7246

1155 W Parkview St
Suite 2J
Bolivar, MO 65613-8598
Phone (417) 328-7702

1160 W Parkview St
CMH Nephrology Clinic
Bolivar, MO 65613-8279
Phone (417) 328-7300

1245 N Butterfield Rd
Bolivar, MO 65613-3017

1500 N Oakland Ave
CMH Diabetes
Bolivar, MO 65613-3099
Phone (417) 328-6040

1501 N Oakland Ave
CMH Oncology Clinic
Bolivar, MO 65613-3020
Phone (417) 328-7200

2001 W Broadway St
Bolivar, MO 65613-1861

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Citizens Memorial Hospital District CurrentSince Mar 15, 2014 Accepting new patients
Citizens Memorial Hospital District CurrentSince Mar 15, 2014 Accepting new patients
Citizens Memorial Healthcare CurrentSince Sep 1, 2009 Accepting new patients
Citizens Memorial Healthcare Family Medicine CurrentSince Sep 1, 2009 Accepting new patients

Locations

1120 S Springfield Ave
Bolivar, MO 65613
Phone (417) 326-4000

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

855 Arduser Dr
Osceola, MO 64776
Phone (417) 646-5075

Organizations & group practices 4

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1629268016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S SPRINGFIELD AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656132512",
            "telephone_number": "417-326-7814",
            "fax_number": "417-326-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S SPRINGFIELD AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656132512",
            "telephone_number": "417-326-7814",
            "fax_number": "417-326-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORTZ",
        "first_name": "PAUL",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-31",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2007033587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

Verify at the official NPI Registry.