Individual provider Active NPI

Randall Tobler, M.D.

  • Obstetrics & Gynecology Physician
  • Memphis, MO
National Provider Identifier
1639190069
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
R2F89 Issued in MO
Practice address
Sigler Ave
R1
Memphis, MO 63555
Phone
(660) 465-2828
Fax
(660) 465-2820
NPI assigned
Jul 21, 2006
Last updated
Mar 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X R2F89 MO Primary

Addresses

Primary practice location

Sigler Ave
R1
Memphis, MO 63555

Mailing address

R1 Box 54
Sigler Ave
Memphis, MO 63555
Phone (660) 465-2828

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20061114000214 MO Practitioner - Obstetrics/GynecologyPractitioner - Gynecological Oncology 0042218711 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Scotland County Memorial Hospital Current Accepting new patients
Macon County Samaritan Hospital CurrentSince Oct 12, 2006 Accepting new patients
Scotland County Memorial Hospital CurrentSince Sep 1, 2006 Accepting new patients
Scotland County Memorial Hospital CurrentSince Sep 1, 2006 Accepting new patients
Scotland County Memorial Hospital Past Accepting new patients
Macon County Samaritan Hospital Obstetrics & Gynecology Past Accepting new patients

Locations

1205 N Missouri St
Macon, MO 63552
Phone (660) 385-3151

450 E Sigler Ave
Memphis, MO 63555
Phone (660) 465-2828

450 E Sigler Ave
Ste A
Memphis, MO 63555
Phone (660) 465-2828

Interoperability endpoints

  • Direct secure messaging: randall.tobler@507399380271108.direct.elationemr.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Scotland County HospitalMemphis, MO, CCN 26Z310 Hospital Corporate Officer (100%)
Corporate Director (100%)
W-2 Managing Employee (100%)
Aug 29, 2014
Aug 29, 2014
Aug 29, 2014

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1639190069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "R1 BOX 54",
            "address_2": "SIGLER AVE",
            "city": "MEMPHIS",
            "state": "MO",
            "postal_code": "63555",
            "telephone_number": "660-465-2828",
            "fax_number": "660-465-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SIGLER AVE",
            "address_2": "R1",
            "city": "MEMPHIS",
            "state": "MO",
            "postal_code": "63555",
            "telephone_number": "660-465-2828",
            "fax_number": "660-465-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBLER",
        "first_name": "RANDALL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "R2F89",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, MO

Sources for this page

Verify at the official NPI Registry.