NPIMap

Individual provider Active NPI

Susan E. Graves, M.D.

  • Family Medicine Physician
  • Brookline, MO
National Provider Identifier
1861581084
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
105942 Issued in MO
Practice address
3203 E Old Stone Ave
Brookline, MO 65619
Phone
(417) 269-1910
Fax
(417) 269-1916
NPI assigned
Oct 12, 2006
Last updated
Nov 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 105942 MO Primary

Addresses

Primary practice location

3203 E Old Stone Ave
Brookline, MO 65619

Mailing address

PO Box 802843
Kansas City, MO 64180-2843
Phone (417) 730-6430

Other identifiers 1

IdentifierTypeStateIssuer
105796OtherMOBCMO

Other names 1

  • Susan Wilt Former name

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
I20080312000331 MO Practitioner - Family Practice 4183709371 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 1254248917, 336 clinicians
Lester E Cox Medical CentersGroup PAC ID 5799787784, 240 clinicians

Practice addresses (Care Compare)

3800 S National Ave
Suite 700
Springfield, MO 65807-5279
Phone (417) 269-8817

510 Hwy 32
Suite C
Lebanon, MO 65536-5303
Phone (417) 269-2278

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.78 of 100Reported as group
Quality
74.39
Promoting interoperability
100
Improvement activities
40
Cost
78.21

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 Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Jan 1, 2008 Accepting new patients
Lester E Cox Medical Centers Family Medicine Current Accepting new patients
Lester E Cox Medical Centers Family Medicine CurrentSince Jan 1, 2008 Accepting new patients
Lester E Cox Medical Centers Family Medicine CurrentSince Oct 4, 2021 Accepting new patients
Lester E. Cox Medical Centers Family Medicine Current Accepting new patients
Lester E. Cox Medical Centers Past Accepting new patients
Cox Barton County Hospital PastSince Oct 1, 2025 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients
Lester E Cox Medical Centers Family Medicine PastSince Jul 21, 2024 Accepting new patients
Lester E Cox Medical Centers PastSince Mar 13, 2022 Accepting new patients

Locations

3203 E Old Stone Ave
Brookline, MO 65619
Phone (417) 269-1910

510 Highway 32
Ste C
Lebanon, MO 65536
Phone (417) 269-2278

5100 N Towne Centre Dr
Ozark, MO 65721
Phone (417) 269-2215

820 S Illinois Ave
Republic, MO 65738
Phone (417) 269-1910

1000 E Primrose St
Ste 360
Springfield, MO 65807
Phone (417) 269-4037

2750 S Campbell Ave
Springfield, MO 65807
Phone (417) 269-2281

3800 S National Ave
Ste 540
Springfield, MO 65807
Phone (417) 269-6262

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

3801 S National Ave
Ste 1122
Springfield, MO 65807

3805 S Kansas Expy
Ste A
Springfield, MO 65807
Phone (417) 269-6896

Interoperability endpoints

  • Direct secure messaging: susan.graves@cernerdirect.coxhealth.com

Ownership & related parties

All facility ownership & control disclosures 23

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

FacilityTypeRoleSince
Cox Medical CentersSpringfield, MO, CCN 260040 Hospital Corporate Director Oct 28, 2021
Cox Medical Center BransonBranson, MO, CCN 260094 Hospital Corporate Director Oct 28, 2021
Cox Monett HospitalMonett, MO, CCN 261329 Hospital Corporate Director Oct 28, 2021
Cox Monett HospitalMonett, MO, CCN 26Z329 Hospital Corporate Director Oct 28, 2021
Cox Barton County HospitalLamar, MO, CCN 261325 Hospital Corporate Director Oct 28, 2021
Cox Barton County HospitalLamar, MO, CCN 26Z325 Hospital Corporate Director Oct 28, 2021
Cox Medical Centers Meyer Orthopedic and SurgicalSpringfield, MO, CCN 265289 Skilled nursing facility Corporate Director Oct 28, 2021
Coxhealth Center Branson WestBranson West, MO, CCN 263480 Rural health clinic Corporate Officer Feb 13, 2023
Coxhealth Center RogersvilleRogersville, MO, CCN 268564 Rural health clinic Corporate Director Nov 10, 2023
Coxhealth CassvilleCassville, MO, CCN 268510 Rural health clinic Corporate Director Jun 26, 2024
Coxhealth Center Mountain GroveMountain Grove, MO, CCN 268571 Rural health clinic Corporate Director Nov 10, 2023
Coxhealth Center SeymourSeymour, MO, CCN 263451 Rural health clinic Corporate Director Nov 10, 2023
Coxhealth Center MarshfieldMarshfield, MO, CCN 263472 Rural health clinic Corporate Director Oct 1, 2022
Coxhealth Family Medicine & ObstetricsBranson, MO, CCN 263496 Rural health clinic Corporate Director Feb 13, 2023
Coxhealth Branson Hills ClinicBranson, MO, CCN 268595 Rural health clinic Corporate Director Nov 17, 2021
Coxhealth Center Mt VernonMount Vernon, MO, CCN 268617 Rural health clinic Corporate Director Mar 6, 2023
Coxhealth Center CraneCrane, MO, CCN 268543 Rural health clinic Corporate Director Mar 7, 2023
Coxhealth MonettMonett, MO, CCN 268735 Rural health clinic Corporate Director Mar 7, 2023
Coxhealth Center AuroraAurora, MO, CCN 268565 Rural health clinic Corporate Director Apr 4, 2023
Golden City ClinicGolden City, MO, CCN 268762 Rural health clinic Corporate Director Nov 29, 2021
Medical One ClinicLamar, MO, CCN 268648 Rural health clinic Corporate Director Nov 29, 2021
Coxhealth Center ForsythForsyth, MO, CCN 268806 Rural health clinic Corporate Director Apr 1, 2024
Coxhealth Womens Center BransonBranson, MO, CCN 268805 Rural health clinic Corporate Director Mar 1, 2024

Owned or controlled facilities with NPI records 25

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

View all 25

Organizations & group practices 10

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 4

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1861581084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802843",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641802843",
            "telephone_number": "417-730-6430",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3203 E OLD STONE AVE",
            "city": "BROOKLINE",
            "state": "MO",
            "postal_code": "65619",
            "telephone_number": "417-269-1910",
            "fax_number": "417-269-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "SUSAN",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2021-11-05",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "105942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMO",
            "identifier": "105796",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "WILT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brookline, MO

Sources for this page

Verify at the official NPI Registry.