NPIMap

Individual provider Active NPI

Dustin Ryan Tompkins, D.O.

  • Internal Medicine Physician
  • Nixa, MO
National Provider Identifier
1790077600
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2014006562 Issued in MO
Practice address
940 W Mount Vernon St
Suite 200
Nixa, MO 65714-9618
Phone
(417) 724-5300
Fax
(417) 724-5303
NPI assigned
May 10, 2011
Last updated
Feb 11, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 2014006562 MO Primary

Addresses

Primary practice location

940 W Mount Vernon St
Suite 200
Nixa, MO 65714-9618

Mailing address

PO Box 505164
Saint Louis, MO 63150-5164
Phone (417) 820-2000

Other identifiers 1

IdentifierTypeStateIssuer
1790077600MedicaidMO

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
I20140813002068 MO Practitioner - Internal Medicine 6901023084 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians
Cherry Health Center, LLCGroup PAC ID 1355317033, 97 clinicians

Practice addresses (Care Compare)

1605 Martin Springs Dr
Rolla, MO 65401-2980

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

3231 S National Ave
Springfield, MO 65807-7304

607 W Battlefield St
Springfield, MO 65807-4123
Phone (417) 869-2000

940 W Mount Vernon St
Nixa, MO 65714-9613

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014006562MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Springfield Current Accepting new patients
Mercy Clinic Springfield Communities Internal Medicine CurrentSince Jan 23, 2018 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Aug 4, 2014 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Aug 4, 2014 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

940 W Mount Vernon St
Ste 100
Nixa, MO 65714
Phone (417) 724-5200

940 W Mount Vernon St
Ste 200
Nixa, MO 65714
Phone (417) 724-5200

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

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

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

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

Interoperability endpoints

  • Direct secure messaging: dtompkins489729@directb.mercy.net
  • Direct secure messaging: dtompkins499389@directc.mercy.net

Ownership & related parties

All facility ownership & control disclosures 15

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

FacilityTypeRoleSince
Mercy Clinic Family Medicine - SteelvilleSteelville, MO, CCN 263850 Rural health clinic Corporate Director Jul 1, 2020
Mercy Clinic - St. JamesSaint James, MO, CCN 263943 Rural health clinic Corporate Director Jul 1, 2020
Mercy Clinic - St. RobertSaint Robert, MO, CCN 263813 Rural health clinic Corporate Director Jul 1, 2020
Mercy Clinic Pediatrics-RollaRolla, MO, CCN 268935 Rural health clinic Corporate Director Jul 1, 2020
Mercy Clinic Family Medicine - Mountain GroveMountain Grove, MO, CCN 263840 Rural health clinic Corporate Director Jul 1, 2020
Mercy Clinic Family Medicine-Branson WestBranson West, MO, CCN 263918 Rural health clinic Corporate Director Jul 1, 2020
Mercy Clinic Family Medicine- CassvilleCassville, MO, CCN 263909 Rural health clinic Corporate Director Jul 1, 2020
Mercy Clinic Family Medicine-El Dorado SpringsEl Dorado Springs, MO, CCN 263900 Rural health clinic Corporate Director Jul 1, 2020
Mercy Clinic Pediatrics-LebanonLebanon, MO, CCN 263831 Rural health clinic Corporate Director Jul 1, 2020
Mercy Clinic Family Medicine-BuffaloBuffalo, MO, CCN 263921 Rural health clinic Corporate Director Jul 1, 2020
Mercy Clinic-Lebanon-Family MedicineLebanon, MO, CCN 263814 Rural health clinic Corporate Director Jul 1, 2020
Mercy Clinic Family Medicine-RichlandRichland, MO, CCN 263934 Rural health clinic Corporate Director Jul 1, 2020
Mercy Clinic - Birch TreeBirch Tree, MO, CCN 263806 Rural health clinic Corporate Director Jul 1, 2020
Mercy Clinic -SalemSalem, MO, CCN 263870 Rural health clinic Corporate Director Jul 1, 2020
Mercy Clinic Family Medicine-Mountain ViewMountain View, MO, CCN 263819 Rural health clinic Corporate Director Jul 1, 2020

Owned or controlled facilities with NPI records 15

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

View all 15

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.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1790077600",
    "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": "417-820-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 W MOUNT VERNON ST",
            "address_2": "SUITE 200",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149618",
            "telephone_number": "417-724-5300",
            "fax_number": "417-724-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMPKINS",
        "first_name": "DUSTIN",
        "middle_name": "RYAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-10",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2014006562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790077600",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nixa, MO

Sources for this page

Verify at the official NPI Registry.