Jose A Atiles, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

112620 Issued in MO

Practice address

1905 W 19TH St
Mountain Grove, MO 65711-1287

Phone

(417) 926-1770

Fax

(417) 926-1785

NPI assigned

Sep 30, 2005

Last updated

Apr 4, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Dixon Family Practice and Internal Medicine, LLC

  • Rural Health Clinic/Center
  • Dixon, MO
  • NPI 1235135682

  Family Medicine

  NPD (past)
• Texas County Memorial Hospital

  dba TCMH - Mountain Grove Clinic

  • Rural Health Clinic/Center
  • Mountain Grove, MO
  • NPI 1265754501
  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1871580241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HAMMOND MILL LN",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657756548",
            "telephone_number": "417-256-2511",
            "fax_number": "417-926-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 W 19TH ST",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111287",
            "telephone_number": "417-926-1770",
            "fax_number": "417-926-1785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 E 19th St",
            "address_purpose": "LOCATION",
            "city": "Mountain Grove",
            "state": "MO",
            "postal_code": "657111114",
            "country_code": "US",
            "telephone_number": "417-926-6563",
            "fax_number": "417-926-5820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATILES",
        "first_name": "JOSE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "112620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "26D2006074",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209187707",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia May Allsman, LPC
• American Homepatient, Inc.
• Shaun Anderson, PHARMD
• Stephanie Dawn Anderson, SLP-A
• Connie Armstrong
• Cynthia Breid Baker, M.S., CCC-SLP
• Lauren Jean Bales, DDS
• David O. Barbe, MD
• Joy M Beeler, MS
• Irma Marie Bell LLC

• Family Medicine Physician in Mountain Grove, MO
• Providers in Mountain Grove, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.