Active NPI
Bruce Edward Preston, MD
- Family Medicine Physician
- West Plains, MO
National Provider Identifier
1972506533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R7937
- Practice address
- 805 N Kentucky St
West Plains, MO 65775-2022 - Phone
- (417) 256-2111
- Fax
- (417) 256-4858
- NPI assigned
- May 27, 2005
- Sex
- Male
- Sole proprietor
- No
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 | R7937 | MO | Primary |
Addresses
Primary practice location
805 N Kentucky St
West Plains, MO 65775-2022
Mailing address
805 N Kentucky St
West Plains, MO 65775-2022
Phone (417) 256-2111
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 599022307 | Medicaid | MO | |
| P00207380 | Other | MEDICARE RR | |
| 200952109 | Medicaid | MO | |
| 599022308 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R7937 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- brucepreston@bcm.allscriptsdirect.net
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201046400000",
"number": "1972506533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 N KENTUCKY ST",
"city": "WEST PLAINS",
"state": "MO",
"postal_code": "657752022",
"telephone_number": "417-256-2111",
"fax_number": "417-256-4858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 N KENTUCKY ST",
"city": "WEST PLAINS",
"state": "MO",
"postal_code": "657752022",
"telephone_number": "417-256-2111",
"fax_number": "417-256-4858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRESTON",
"first_name": "BRUCE",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-27",
"last_updated": "2008-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "R7937",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "599022307",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "P00207380",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200952109",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "599022308",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Plains, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.