NPIMap

Individual provider Active NPI

Ryan Lueck, NP

  • Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1871041566
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2016029747 Issued in MO
Practice address
3801 S National Ave
Suite 900
Springfield, MO 65807-5210
Phone
(417) 875-3087
Fax
(417) 875-2822
NPI assigned
Sep 12, 2016
Last updated
Dec 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2016029747 MO Primary

Addresses

Primary practice location

3801 S National Ave
Suite 900
Springfield, MO 65807-5210

Mailing address

PO Box 9007
Springfield, MO 65808-9007
Phone (417) 875-3000

Other identifiers 2

IdentifierTypeStateIssuer
1871041566MedicaidMO
420037004MedicaidMO

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
I20161012001401 MO Practitioner - Nurse Practitioner 5092003764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 1254248917, 336 clinicians

Practice addresses (Care Compare)

3801 S National
Suite 900
Springfield, MO 65807-5210
Phone (417) 875-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.52 of 100Reported as group
Quality
61.64
Promoting interoperability
100
Improvement activities
40
Cost
76.77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2016029747MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Oct 1, 2022 Accepting new patients
Lester E Cox Medical Centers Current Accepting new patients
Barton County Memorial Hospital Past Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Skaggs Community Hospital Association Past Accepting new patients

Locations

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

1001 E Primrose St
Springfield, MO 65807
Phone (417) 875-3434

3800 S National Ave
Ste 400
Springfield, MO 65807
Phone (417) 269-9842

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

3801 S National Ave
Ste 900
Springfield, MO 65807
Phone (417) 269-2710

Organizations & group practices 7

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 3

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": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1871041566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658089007",
            "telephone_number": "417-875-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S NATIONAL AVE",
            "address_2": "SUITE 900",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075210",
            "telephone_number": "417-875-3087",
            "fax_number": "417-875-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUECK",
        "first_name": "RYAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-12",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2016029747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871041566",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420037004",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.