Individual provider Active NPI

Michael L Hearndon, DO

  • Interventional Pain Medicine Physician
  • Galena, KS
National Provider Identifier
1972625853
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
534506 Issued in KS
Practice address
444 Four States Dr
Suite 1
Galena, KS 66739-4324
Phone
(620) 783-4441
Fax
(620) 783-4090
NPI assigned
Apr 4, 2007
Last updated
Apr 7, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 062351 GA
Interventional Pain Medicine Physician 208VP0014X 534506 KS Primary
Interventional Pain Medicine Physician 208VP0014X 5654 OK

Addresses

Primary practice location

444 Four States Dr
Suite 1
Galena, KS 66739-4324

Mailing address

PO Box 2546
Joplin, MO 64803-2546
Phone (620) 783-4441

Other identifiers 1

IdentifierTypeStateIssuer
200300250AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, OK, MO3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20100902000033 KS Practitioner - Pain ManagementPractitioner - Physical Medicine and Rehabilitation 4183774508 Reassigns benefits to 1 organization
I20150323001628 OK Practitioner - Physical Medicine and Rehabilitation 4183774508 Reassigns benefits to 1 organization
I20200603000399 MO Practitioner - Orthopedic Surgery 4183774508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
West Virginia School of Osteopathic Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, shared by 3 NPIs, 288 clinicians

Practice addresses (Care Compare)

100 Mercy Way
430 Mercy Clinic Joplin Orthopedics
Joplin, MO 64804-4524
Phone (417) 556-2278

1121 Neo Loop
Mercy Clinic Orthopedics Grove
Grove, OK 74344-6046
Phone (877) 783-4441

444 Four States Dr
Suite 1
Galena, KS 66739-4325
Phone (877) 783-4441

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5654OKMDOral and Maxillofacial Surgery (Dentist)
534506KSMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Joplin LLC CurrentSince May 2, 2020 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Jan 25, 2020 Accepting new patients
Mercy Clinic Joplin, LLC CurrentSince Jan 25, 2020 Accepting new patients
Georgia Pain Physicians PC Interventional Pain Medicine Past Accepting new patients
Orthopaedic Specialists of the Four States LLC Past Accepting new patients
Mercy Specialty Hospital Southeast Kansas Interventional Pain Medicine Past Accepting new patients

Locations

220 N Pennsylvania Ave
Columbus, KS 66725
Phone (620) 429-2545

403 Woodland Hills Blvd
Fort Scott, KS 66701
Phone (417) 556-4762

444 Four States Dr
Ste 1
Galena, KS 66739
Phone (877) 783-4441

2701 S Rouse St
Pittsburg, KS 66762
Phone (620) 232-3399

94 Main St
Cassville, MO 65625
Phone (417) 782-7722

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

100 Mercy Way
#430
Joplin, MO 64804
Phone (417) 556-2278

2550 Lusk Dr
Neosho, MO 64850
Phone (417) 451-2060

1121 Neo Loop
Grove, OK 74344
Phone (877) 783-4441

10 S Treaty Rd
Miami, OK 74354
Phone (918) 238-2410

Interoperability endpoints

  • Direct secure messaging: mhearndon@o4s.mdlogic.direct-ci.com
  • Direct secure messaging: mhearndon804816@directc.mercy.net

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 6

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1972625853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2546",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648032546",
            "telephone_number": "620-783-4441",
            "fax_number": "620-783-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 FOUR STATES DR",
            "address_2": "SUITE 1",
            "city": "GALENA",
            "state": "KS",
            "postal_code": "667394324",
            "telephone_number": "620-783-4441",
            "fax_number": "620-783-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARNDON",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "062351",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "KS",
            "license": "534506",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OK",
            "license": "5654",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200300250A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galena, KS

Sources for this page

Verify at the official NPI Registry.