Michael K. Gaddy, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

112033 Issued in MO

Practice address

104 East Highway 60
Mountain View, MO 65548

Phone

(417) 934-2251

Fax

(417) 934-2871

NPI assigned

Oct 19, 2006

Last updated

Jul 15, 2008By 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

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Mercy Clinic Springfield Communities

  dba Mercy Clinic Family Medicine-Willow Springs

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment NPD
• Big Springs Medical Association

  dba Missouri Highlands Health Care

  • Federally Qualified Health Center (FQHC)
  • Van Buren, MO
  • NPI 1225045321
  Medicare reassignment
• Big Springs Medical Association

  dba Missouri Highlands Health Care

  • Federally Qualified Health Center (FQHC)
  • Doniphan, MO
  • NPI 1366074692
  NPD
• Big Springs Medical Association

  dba Missouri Highlands Health Care

  • Federally Qualified Health Center (FQHC)
  • Poplar Bluff, MO
  • NPI 1972466233
  NPD
• Mercy Clinic Springfield Communities

  dba Mercy Clinic-Agape Family Medicine

  • Rural Health Clinic/Center
  • Lebanon, MO
  • NPI 1215066956
  NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1871675702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 EAST HIGHWAY 60",
            "city": "MOUNTAIN VIEW",
            "state": "MO",
            "postal_code": "65548",
            "telephone_number": "417-934-2251",
            "fax_number": "417-934-2871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDY",
        "first_name": "MICHAEL",
        "middle_name": "K.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "112033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Wayne David, RPH
• Shamuel Meyerovich Day, MD, MPH
• Beverly J. Denton, FNP-C
• Don Andrew Dodd, DPT
• Julie Denise Dunn, LPC
• Kendra L Harralston, APRN
• Dawn Marie Henry
• Pearl Ann Hunter, FNP
• Katie Johnston
• Anne Kennedy, RPH

• Medical Physician Assistant in Mountain View, MO
• Providers in Mountain View, MO by specialty
• Medical Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.