Individual provider Active NPI

Derek J Magers, DDS

  • General Practice Dentistry
  • Springfield, MO
National Provider Identifier
1801234828
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2013016359 Issued in MO
Practice address
1200 E Woodhurst Dr
Building U
Springfield, MO 65804-4261
Phone
(417) 887-3100
NPI assigned
Jun 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2013016359 MO Primary

Addresses

Primary practice location

1200 E Woodhurst Dr
Building U
Springfield, MO 65804-4261

Mailing address

1200 E Woodhurst Dr
Building U
Springfield, MO 65804-4261
Phone (417) 887-3100

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160915000785 MO Order and Referring Only - DentistPractitioner - Dentist 7012203128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013016359MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ascend Dental Design, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1801234828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E WOODHURST DR",
            "address_2": "BUILDING U",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044261",
            "telephone_number": "417-887-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E WOODHURST DR",
            "address_2": "BUILDING U",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044261",
            "telephone_number": "417-887-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGERS",
        "first_name": "DEREK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2013016359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.