NPIMap

Individual provider Active NPI

David P. Brummett, M.D.

  • Diagnostic Radiology Physician
  • Columbia, MO
National Provider Identifier
1720075823
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2002006504 Issued in MO
Practice address
1502 E Broadway
Suite 210
Columbia, MO 65201-8076
Phone
(573) 443-4591
Fax
(573) 874-1369
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 2002006504 MO
Diagnostic Radiology Physician 2085R0202X 2002006504 MO Primary

Addresses

Primary practice location

1502 E Broadway
Suite 210
Columbia, MO 65201-8076

Mailing address

1502 E Broadway
Suite 210
Columbia, MO 65201-8076
Phone (573) 443-4591

Other practice location 1

1509 Union Ave
Moberly, MO 65270-9407
Phone (660) 263-8986

Other identifiers 1

IdentifierTypeStateIssuer
205811300MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address david.brummett.1@2622.direct.athenahealth.com

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
I20051219000659 MO Practitioner - Diagnostic Radiology 0648292656 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Kansas School of Med (KC/Wich/Sal), 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moberly Medical Clinics IncGroup PAC ID 8426031592, 11 clinicians
John Fitzgibbon Memorial Hospital IncGroup PAC ID 2567351570, 45 clinicians

Practice addresses (Care Compare)

1515 Union Ave
Moberly, MO 65270-9407
Phone (660) 263-2400

2305 S 65 Hwy
Marshall, MO 65340-3702

2305 S Hwy 65
Marshall, MO 65340-3702

Hospital & facility affiliations

  • Fitzgibbon Hospital Hospital, Marshall, MO, CCN 260142
  • Moberly Regional Medical Center Hospital, Moberly, MO, CCN 260074
  • Boone Hospital Center Hospital, Columbia, MO, CCN 260068
  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141
  • Bothwell Regional Health Center Hospital, Sedalia, MO, CCN 260009

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Moberly Medical Clinics Inc CurrentSince Nov 1, 2021 Accepting new patients
Moberly Medical Clinics Inc CurrentSince Nov 1, 2021 Accepting new patients
Ernst Radiology Clinic, Inc Diagnostic Radiology CurrentSince Aug 5, 2022 Accepting new patients
John Fitzgibbon Memorial Hospital Inc. Diagnostic Radiology CurrentSince Nov 15, 2023 Accepting new patients
John Fitzgibbon Memorial Hospital Inc. CurrentSince Nov 15, 2023 Accepting new patients
Indiana University Radiology Associates, Inc. Neuroradiology Past Accepting new patients

Locations

130 E Lockling St
Brookfield, MO 64628
Phone (660) 258-1050

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

2305 S Highway 65
Marshall, MO 65340
Phone (660) 831-3730

1515 Union Ave
Moberly, MO 65270
Phone (660) 263-2400

1509 Union Ave
Moberly, MO 65270
Phone (660) 263-2986

Interoperability endpoints

  • Direct secure messaging: david.brummett.1@2622.direct.athenahealth.com

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 16

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1720075823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 E BROADWAY",
            "address_2": "SUITE 210",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018076",
            "telephone_number": "573-443-4591",
            "fax_number": "573-874-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 E BROADWAY",
            "address_2": "SUITE 210",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018076",
            "telephone_number": "573-443-4591",
            "fax_number": "573-874-1369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1509 Union Ave",
            "address_purpose": "LOCATION",
            "city": "Moberly",
            "state": "MO",
            "postal_code": "652709407",
            "country_code": "US",
            "telephone_number": "660-263-8986",
            "fax_number": "660-269-2943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUMMETT",
        "first_name": "DAVID",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MO",
            "license": "2002006504",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2002006504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205811300",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "david.brummett.1@2622.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1509 Union Ave",
            "city": "Moberly",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652709407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.