Individual provider Active NPI

Omagbemi Alex Buwa, MD

  • Psychiatry Physician
  • Columbia, MO
National Provider Identifier
1922597871
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2021026576 Issued in MO
Practice address
3401 Berrywood Dr
Columbia, MO 65201-8372
Phone
(573) 777-8330
NPI assigned
May 7, 2018
Last updated
Feb 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2021026576 MO Primary

Addresses

Primary practice location

3401 Berrywood Dr
Columbia, MO 65201-8372

Mailing address

2885 W Battlefield St
Springfield, MO 65807-3952
Phone (417) 761-5000

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210825001615 MO Practitioner - Psychiatry 3678828928 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Burrell IncGroup PAC ID 4486548625, 217 clinicians
State of MissouriGroup PAC ID 1456254226, 48 clinicians

Practice addresses (Care Compare)

3401 Berrywood Dr
Columbia, MO 65201-6515
Phone (573) 777-8300

600 E 5TH St
Fulton State Hospital
Fulton, MO 65251-1793
Phone (573) 592-4100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Missouri Psychiatry CurrentSince Jul 7, 2021 Accepting new patients
Burrell, Inc. CurrentSince Jan 20, 2025 Accepting new patients
Burrell, Inc. CurrentSince Jan 20, 2025 Accepting new patients
State of Missouri Psychiatry CurrentSince Jul 7, 2021 Accepting new patients
University of Missouri, Columbia Past Accepting new patients

Locations

3401 Berrywood Dr
Columbia, MO 65201
Phone (573) 777-7530

600 E 5th St
Fulton, MO 65251
Phone (573) 592-2623

1300 E Bradford Pkwy
#H
Springfield, MO 65804

2885 W Battlefield St
Springfield, MO 65807
Phone (417) 761-5800

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1922597871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 W BATTLEFIELD ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658073952",
            "telephone_number": "417-761-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 BERRYWOOD DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018372",
            "telephone_number": "573-777-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUWA",
        "first_name": "OMAGBEMI",
        "middle_name": "ALEX",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-07",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2021026576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.