Myron D. Brockman, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R2A87 Issued in MO

Practice address

3800 S National Ave
#600
Springfield, MO 65807-5209

Phone

(417) 269-1499

Fax

(417) 269-1459

NPI assigned

Aug 21, 2006

Last updated

Oct 13, 2015By 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 Medicine

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1740395375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4046",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658084046",
            "telephone_number": "417-269-7241",
            "fax_number": "417-269-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 S NATIONAL AVE",
            "address_2": "#600",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075209",
            "telephone_number": "417-269-1499",
            "fax_number": "417-269-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "MYRON",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R2A87",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "27635",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201656642",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaliyah Marie Brizendine
• Todd Brizendine, LPC
• Broadbent Rehab LLC
• Loren E Broaddus, M.D.
• Don L Brockman, MD
• Madison Mackenzie Broderick
• Amanda Christine Brodeur, MD
• Christian Edward Brodeur, MD
• Kenneth Brodrick, M.S., LPC
• Stephanie M Brodwater, MS, LPC

• Internal Medicine Physician in Springfield, MO
• Providers in Springfield, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; 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.