NPIMap

Individual provider Active NPI

Philip Stitzer, DO

  • Family Medicine Physician
  • Moberly, MO
National Provider Identifier
1881693323
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R7J97 Issued in MO
Practice address
1501 Union Ave
Suite C & D
Moberly, MO 65270-9469
Phone
(660) 263-4770
Fax
(660) 263-2228
NPI assigned
Jul 18, 2005
Last updated
Apr 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 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 R7J97 MO Primary

Addresses

Primary practice location

1501 Union Ave
Suite C & D
Moberly, MO 65270-9469

Mailing address

1501 Union Ave
Moberly, MO 65270-9469
Phone (660) 263-4770

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address philip.stitzer.1@2622.direct.athenahealth.com Direct
Direct Messaging Address philip.stitzer.2@2622.direct.athenahealth.com

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
I20100422000225 MO Practitioner - Family Practice 7618004755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moberly Hospital Company LLCGroup PAC ID 9436052230, 10 clinicians

Practice addresses (Care Compare)

1501 Union Ave
Moberly, MO 65270-9469

413 W 2ND St
Chariton Valley Family Medicine
Salisbury, MO 65281-1405
Phone (660) 388-7084

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
R7J97MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moberly Hospital Company LLC Current Accepting new patients
Moberly Hospital Company LLC CurrentSince Mar 26, 2013 Accepting new patients
Moberly Hospital Company LLC CurrentSince Mar 26, 2013 Accepting new patients
Moberly Hospital Company LLC Past Accepting new patients
Kirksville Missouri Hospital Company LLC Past Accepting new patients
Midwest Heart and Vein Center, LLC Past Accepting new patients

Locations

1501 Union Ave
Moberly, MO 65270
Phone (660) 263-4770

1501 Union Ave
Ste 1B
Moberly, MO 65270
Phone (660) 263-4770

1501 Union Ave
Ste B
Moberly, MO 65270
Phone (660) 263-4600

1501 Union Ave
Ste C
Moberly, MO 65270
Phone (660) 263-4737

1501 Union Ave
Ste Cd
Moberly, MO 65270
Phone (660) 263-4770

1515 Union Ave
Moberly, MO 65270
Phone (660) 263-2400

Interoperability endpoints

  • Direct secure messaging: philip.stitzer.1@2622.direct.athenahealth.com

Organizations & group practices 6

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 12

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1881693323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 UNION AVE",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652709469",
            "telephone_number": "660-263-4770",
            "fax_number": "660-263-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 UNION AVE",
            "address_2": "SUITE C & D",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652709469",
            "telephone_number": "660-263-4770",
            "fax_number": "660-263-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STITZER",
        "first_name": "PHILIP",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R7J97",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "philip.stitzer.1@2622.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1501 Union Ave",
            "address_2": "Suite C & D",
            "city": "Moberly",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652709469",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "philip.stitzer.2@2622.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1501 Union Ave",
            "city": "Moberly",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652709469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moberly, MO

Sources for this page

Verify at the official NPI Registry.