NPIMap

Individual provider Active NPI

Robert Medley, NP

  • Nurse Practitioner
  • West Plains, MO
National Provider Identifier
1972771079
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2001017804 Issued in MO
Practice address
1100 N Kentucky Ave
West Plains, MO 65775-2029
Phone
(417) 257-6778
NPI assigned
Feb 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2001017804 MO Primary

Addresses

Primary practice location

1100 N Kentucky Ave
West Plains, MO 65775-2029

Mailing address

3020 Saint Johns Blvd
Suite E-3
Joplin, MO 64804-1564
Phone (417) 659-6876

Other practice location 1

3020 Saint Johns Blvd
Suite E-3
Joplin, MO 64804-1564
Phone (417) 659-6876

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
I20080409000154 MO Practitioner - Nurse Practitioner 5698852028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Columbia School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ozarks Medical CenterGroup PAC ID 3870491863, 166 clinicians
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, 1,121 clinicians

Practice addresses (Care Compare)

1100 N Kentucky Ave
West Plains, MO 65775-2029
Phone 41725691116036

1235 E Cherokee St
Springfield, MO 65804-2203

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

Hospital & facility affiliations

  • Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065
  • Ozarks Healthcare Hospital, West Plains, MO, CCN 260078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Oct 1, 2012 Accepting new patients
Ozarks Medical Center CurrentSince Mar 11, 2020 Accepting new patients
Ozarks Medical Center CurrentSince Mar 11, 2020 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Oct 1, 2012 Accepting new patients
Ferrell Duncan Clinic, Inc Past Accepting new patients
Mercy Clinic Joplin LLC Past Accepting new patients

Locations

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

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

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

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1001 E Primrose St
Springfield, MO 65807
Phone (417) 875-3434

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

1100 N Kentucky Ave
West Plains, MO 65775
Phone (417) 257-5959

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1972771079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 SAINT JOHNS BLVD",
            "address_2": "SUITE E-3",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041564",
            "telephone_number": "417-659-6876",
            "fax_number": "417-626-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N KENTUCKY AVE",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752029",
            "telephone_number": "417-257-6778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3020 Saint Johns Blvd",
            "address_2": "Suite E-3",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648041564",
            "country_code": "US",
            "telephone_number": "417-659-6876",
            "fax_number": "417-626-7588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDLEY",
        "first_name": "ROBERT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-12",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2001017804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

Verify at the official NPI Registry.