Grant Michael Barnum, D.O.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

DOR4GO2 Issued in MO

Practice address

1870 Bagnell Dam Blvd
Lake Ozark, MO 65049-8658

Phone

(573) 365-2318

Fax

(573) 365-3009

NPI assigned

Jul 14, 2005

Last updated

May 5, 2008By 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209945600000",
    "number": "1639178445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DR",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 BAGNELL DAM BLVD",
            "city": "LAKE OZARK",
            "state": "MO",
            "postal_code": "650498658",
            "telephone_number": "573-365-2318",
            "fax_number": "573-365-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNUM",
        "first_name": "GRANT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2008-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "DOR4GO2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00303899",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242978211",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• B &B Eyecare, LLC (Family Eyecare Associates)
• Mark Roy Bagby, DDS
• Stephanie Ballard, RN
• Sara Barlett, LMSW
• Barnes Medical Clinic PC
• Beacon of Hope Counseling Services
• Janelle Blackwell
• Alyssa Jayne Bonney
• Lola Booker
• Daniel Bradley, PLMFT

• Geriatric Medicine (Internal Medicine) Physician in Lake Ozark, MO
• Providers in Lake Ozark, MO by specialty
• Geriatric Medicine (Internal Medicine) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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.