Active NPI
Dorothy M Munch, D.O.
- Family Medicine Physician
- Poplar Bluff, MO
National Provider Identifier
1922003276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 36720
- Practice address
- 930 N Westwood Blvd
Poplar Bluff, MO 63901-4242 - Phone
- (573) 778-1620
- Fax
- (573) 778-1486
- NPI assigned
- Jun 14, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 36720 | MO | Primary |
Addresses
Primary practice location
930 N Westwood Blvd
Poplar Bluff, MO 63901-4242
Mailing address
930 N Westwood Blvd
Poplar Bluff, MO 63901-4242
Phone (573) 778-1620
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 915331 | Other | MO | UNITED HEALTHCARE ID # |
| 242613081 | Medicaid | MO | |
| 1922003276 | Other | MO | NPI NUMBER |
| 26D1003101 | Other | MO | CLIA CERTIFICATION NUMBER |
| 242613073 | Medicaid | MO | |
| 164653 | Other | MO | BLUE CROSS BLUE SHIELD |
| 460494181 | Other | MO | TAX IDENTIFICATION NUMBER |
| 000000E14668 | Other | MO | PREMIER BENEFITS ID # |
Other names 1
- Mrs. Dorothy M Munch
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
930 N Westwood Blvd
Poplar Bluff, MO 63901-4242
Phone (573) 778-1620
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 19.77 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 65.9
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36720 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Poplar Bluff, MO
- NPI 1952550485
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Poplar Bluff, MO
- NPI 1700831724
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723680000000",
"number": "1922003276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "930 N WESTWOOD BLVD",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639014242",
"telephone_number": "573-778-1620",
"fax_number": "573-778-1486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 N WESTWOOD BLVD",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639014242",
"telephone_number": "573-778-1620",
"fax_number": "573-778-1486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNCH",
"first_name": "DOROTHY",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-06-14",
"last_updated": "2024-08-15",
"certification_date": "2024-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "36720",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE ID #",
"identifier": "915331",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "242613081",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI NUMBER",
"identifier": "1922003276",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA CERTIFICATION NUMBER",
"identifier": "26D1003101",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "242613073",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "164653",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION NUMBER",
"identifier": "460494181",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREMIER BENEFITS ID #",
"identifier": "000000E14668",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DOROTHY",
"last_name": "MUNCH",
"middle_name": "M",
"prefix": "MRS.",
"credential": "D.O.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Poplar Bluff, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.