Individual provider Active NPI

Bethany S Lemmon, PA-C

  • Physician Assistant
  • Bolivar, MO
National Provider Identifier
1710127642
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2009004297 Issued in MO
Practice address
1155 W Parkview St Ste 1G
Bolivar, MO 65613-8597
Phone
(417) 326-8700
Fax
(417) 777-8173
NPI assigned
Mar 5, 2009
Last updated
Aug 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2009004297 MO Primary

Addresses

Primary practice location

1155 W Parkview St Ste 1G
Bolivar, MO 65613-8597

Mailing address

PO Box 505673
Saint Louis, MO 63150-5673

Other practice location 1

101 Skaggs Rd Ste 103
Branson, MO 65616-2062
Phone (000) 000-0000

Other practice location 2

1000 E Hwy 60
Monett, MO 65708-8258
Phone (000) 000-0000

Other practice location 3

3525 S National Ave Ste 101
Springfield, MO 65807-7315
Phone (000) 000-0000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090608000594 MO Practitioner - Physician Assistant 5496805707 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 1254248917, 336 clinicians

Practice addresses (Care Compare)

1000 E Primrose St
Suite 360
Springfield, MO 65807-5293
Phone (417) 269-4037

13852 US Hwy 160
Forsyth, MO 65653-5156
Phone (417) 546-3500

3525 S National Ave St
Springfield, MO 65807-7315

3801 S National Ave
Springfield, MO 65807-5210
Phone (417) 269-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Sep 23, 2024 Accepting new patients
Skaggs Community Hospital Association CurrentSince Sep 23, 2024 Accepting new patients
Skaggs Community Hospital Association CurrentSince Sep 23, 2024 Accepting new patients
Citizens Memorial Healthcare CurrentSince Jun 15, 2011 Accepting new patients
Citizens Memorial Healthcare Physician Assistant CurrentSince Jun 15, 2011 Accepting new patients
Cox-Monett Hospital, Inc. CurrentSince Sep 23, 2024 Accepting new patients
Lester E. Cox Medical Centers CurrentSince Sep 23, 2024 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients

Locations

1155 W Parkview St
Ste 1G
Bolivar, MO 65613
Phone (417) 326-8700

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

101 Skaggs Rd
Ste 103
Branson, MO 65616
Phone (417) 335-7121

1000 E US Highway 60
Monett, MO 65708
Phone (417) 354-1269

1000 E Primrose St
Ste 360
Springfield, MO 65807
Phone (417) 269-4037

3525 S National Ave
Springfield, MO 65807
Phone (417) 269-9200

3525 S National Ave
Ste 101
Springfield, MO 65807
Phone (417) 269-9950

Organizations & group practices 11

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1710127642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505673",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 W PARKVIEW ST STE 1G",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656138597",
            "telephone_number": "417-326-8700",
            "fax_number": "417-777-8173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Skaggs Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Branson",
            "state": "MO",
            "postal_code": "656162062",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 E Hwy 60",
            "address_purpose": "LOCATION",
            "city": "Monett",
            "state": "MO",
            "postal_code": "657088258",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3525 S National Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658077315",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEMMON",
        "first_name": "BETHANY",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-05",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2009004297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

Verify at the official NPI Registry.