NPIMap

Individual provider Active NPI

Adam R Wozniak, D.O.

  • Family Medicine Physician
  • Hollister, MO
National Provider Identifier
1730146507
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2005014705 Issued in MO
Practice address
290 Clift CT
Hollister, MO 65672-5947
Phone
(417) 336-4355
Fax
(417) 337-5141
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2005014705 MO Primary
Family Medicine Physician 207Q00000X E4814 AR

Addresses

Primary practice location

290 Clift CT
Hollister, MO 65672-5947

Mailing address

PO Box 505164
Saint Louis, MO 63150-5164
Phone (417) 829-4620

Other practice location 1

3060 S Fremont Ave
Springfield, MO 65804-4210
Phone (417) 771-5367

Other identifiers 4

IdentifierTypeStateIssuer
5N643OtherARBCBS
5N643OtherAR BCBS
163841003MedicaidAR
1730146507MedicaidMO

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
I20060214000082 MO Practitioner - Family Practice 6608881552 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

3045 S National Ave
Springfield, MO 65804-4268

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E4814ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Apr 9, 2018 Accepting new patients
Mercy Hospital Springfield CurrentSince Oct 21, 2024 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince May 17, 2011 Accepting new patients
Mercy Hospital Springfield CurrentSince Oct 21, 2024 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince May 17, 2011 Accepting new patients
Mercy Southern Missouri Ambulatory Services LLC CurrentSince Sep 29, 2025 Accepting new patients
John Patton Black,MD Past Accepting new patients
Preferred Medical Associates LLC PastSince Nov 2, 2009 Accepting new patients
Lincoln County Hospital Past Accepting new patients

Locations

290 Clift Ct
Hollister, MO 65672
Phone (417) 336-4355

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2150 W Republic Rd
Ste 112
Springfield, MO 65807
Phone (417) 986-1291

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

Interoperability endpoints

  • Direct secure messaging: awozniak198788@directb.mercy.net

Organizations & group practices 9

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.

Hospital & facility affiliations 9

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1730146507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505164",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505164",
            "telephone_number": "417-829-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 CLIFT CT",
            "city": "HOLLISTER",
            "state": "MO",
            "postal_code": "656725947",
            "telephone_number": "417-336-4355",
            "fax_number": "417-337-5141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3060 S Fremont Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658044210",
            "country_code": "US",
            "telephone_number": "417-771-5367",
            "fax_number": "417-771-5649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOZNIAK",
        "first_name": "ADAM",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2005014705",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E4814",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5N643",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BCBS",
            "identifier": "5N643",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163841003",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730146507",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollister, MO

Sources for this page

Verify at the official NPI Registry.