NPIMap

Individual provider Active NPI

Mark Jeffery McNabb, D.O.

  • Internal Medicine Physician
  • Cape Girardeau, MO
National Provider Identifier
1942337522
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO100129 Issued in MO
Practice address
3260 Lexington Ave
Cape Girardeau, MO 63701-2609
Phone
(573) 335-5057
Fax
(573) 335-1552
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO100129 MO Primary

Addresses

Primary practice location

3260 Lexington Ave
Cape Girardeau, MO 63701-2609

Mailing address

3260 Lexington Ave
Cape Girardeau, MO 63701-2609
Phone (573) 335-5057

Other identifiers 1

IdentifierTypeStateIssuer
6504OtherMOANTHEM BLUE CROSS BLUE SH

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
I20031103000071 MO Practitioner - Internal Medicine 7012829724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1990
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Health Facilities Rehab Services IncGroup PAC ID 3476679226, 152 clinicians

Practice addresses (Care Compare)

1102 Sikes Ave
Sikeston, MO 63801-5021

3260 Lexington Ave
Cape Girardeau, MO 63701-2609

Hospital & facility affiliations

  • Grace Reliant Health Services, LLC Home health agency, Cape Girardeau, MO, CCN 267646
  • Americare Home Health Solutions Home health agency, Farmington, MO, CCN 267622
  • Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110
  • Saint Francis Medical Center Hospital, Cape Girardeau, MO, CCN 260183
  • Missouri Delta Medical Center Hospital, Sikeston, MO, CCN 260113
  • Barnes-Jewish West County Hospital Hospital, Creve Coeur, MO, CCN 260162
  • Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032
  • Chateau Girardeau Nursing home, Cape Girardeau, MO, CCN 265142

Merit-based Incentive Payment System (MIPS)

Final score
26.05 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
86.82

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO100129MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Missouri Internal Medicine, PC Internal Medicine CurrentSince Nov 30, 2012 Accepting new patients

Locations

3260 Lexington Ave
Cpe Girardeau, MO 63701
Phone (573) 335-5057

Interoperability endpoints

  • Direct secure messaging: admin@smim3260.e-mdsdirect.com
  • Direct secure messaging: mark-mcnabb@smim3260.e-mdsdirect.com

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.

Hospital & facility affiliations 9

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942337522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 LEXINGTON AVE",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012609",
            "telephone_number": "573-335-5057",
            "fax_number": "573-335-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 LEXINGTON AVE",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012609",
            "telephone_number": "573-335-5057",
            "fax_number": "573-335-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNABB",
        "first_name": "MARK",
        "middle_name": "JEFFERY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "DO100129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "6504",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.