James R Wirkkula, D.O.
Individual provider Active NPI Family Medicine Physician · Holden, MO
NPI 1861405342 · NPPES record last updated Nov 10, 2015
Key facts
- NPI
- 1861405342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 1999141384 (MO)
- Practice address
- 807 W 2ND St
Holden, MO 64040-1291 - Phone
- (816) 735-7979
- Fax
- (816) 735-7898
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bates County Memorial Hospital
Practice addresses (Care Compare)
102 E Main St
Adrian, MO 64720-8204
Phone (816) 297-2640
615 W Nursery St
Butler, MO 64730-1840
Phone (660) 200-2004
617 W Nursery St
Butler, MO 64730-1840
Phone (660) 200-7133
Hospital & facility affiliations
- Amedisys Home Health of Missouri
- Bates County Memorial Hospital
- Cass Regional Medical Center
- St Joseph Medical Center
- Medicalodges Butler
- Baptist Homes of Adrian
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060126001030 | MO | Practitioner - Family Practice | 4981656220 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1999141384 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mawd Pathologists, LLC | Current | Accepting new patients | |
| Bates County Memorial Hospital | Current |
Accepting new patients | |
| Mawd Pathology Group Inc | Current | Accepting new patients | |
| Bates County Memorial Hospital | Family Medicine | Current |
Accepting new patients |
| The Covenant Group PA | Past | Accepting new patients |
Locations
8929 Parallel Pkwy
Kansas City, KS 66112
Phone (913) 596-3930
3500 S 4th St
Leavenworth, KS 66048
Phone (913) 469-1411
102 E Main St
Adrian, MO 64720
Phone (816) 297-2640
617 W Nursery St
Butler, MO 64730
Phone (660) 200-2004
615 W Nursery St
Butler, MO 64730
Phone (660) 200-2004
Interoperability endpoints
- james.wirkkula.1@15058.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1999141384 | MO | Yes |
Addresses
Primary practice location
807 W 2ND St
Holden, MO 64040-1291
Mailing address
PO Box 537
Warrensburg, MO 64093-0537
Phone (816) 735-7979
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207253204 | Medicaid | MO |
Other providers in Holden, MO
- The Dyslexia Den
- Audra Deborah Tinnin
- Trevi Enterprises LLC
- Dana J Van Meter Patton
- Wilkinson Pharmacy Inc
All providers in Holden, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.