Individual provider Active NPI

Pamela Jean McCool, D.O.

  • Obstetrics & Gynecology Physician
  • Clinton, MO
National Provider Identifier
1982893608
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4534 Issued in OK
Practice address
1602 N 2ND St
Clinton, MO 64735-1192
Phone
(660) 885-8171
NPI assigned
Oct 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4534 OK Primary

Addresses

Primary practice location

1602 N 2ND St
Clinton, MO 64735-1192

Mailing address

1602 N 2ND St
Clinton, MO 64735-1192
Phone (660) 885-8171

Other identifiers 2

IdentifierTypeStateIssuer
7870000OtherMOGROUP MEDICARE NUMBER 7870000. INDIVIDUAL NUMBER IS PENDING
7870000026OtherMOPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20111128000027 MO Practitioner - Obstetrics/Gynecology 6608948203 Reassigns benefits to 1 organization
I20210730001189 IA Practitioner - Obstetrics/Gynecology 6608948203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Oklahoma State University College of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4480 Utica Ridge Rd
Suite 108
Bettendorf, IA 52722-1644
Phone (563) 742-5280

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4534OKMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Valley Memorial Hospital District CurrentSince Oct 6, 2011 Accepting new patients
Iowa Physicians Clinic Medical Foundation Obstetrics & Gynecology CurrentSince Aug 30, 2021 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Golden Valley Memorial Hospital District CurrentSince Oct 6, 2011 Accepting new patients
Golden Valley Memorial Hospital District Current Accepting new patients
Cherokee Nation PastSince Mar 1, 2021 Accepting new patients
Trinity Medical Center Past Accepting new patients
Cherokee Nation Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 108
Bettendorf, IA 52722
Phone (563) 324-7272

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

1602 N 2nd St
Clinton, MO 64735
Phone (660) 885-8171

1600 N 2nd St
Clinton, MO 64735
Phone (660) 885-8171

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/2d405cde-1d8b-4a50-adff-ca7776cd856e/
  • Direct secure messaging: pmccool826105@direct.unitypoint.org

Organizations & group practices 8

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 3

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": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1982893608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 N 2ND ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647351192",
            "telephone_number": "660-885-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 N 2ND ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647351192",
            "telephone_number": "660-885-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOOL",
        "first_name": "PAMELA",
        "middle_name": "JEAN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "4534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE NUMBER 7870000.  INDIVIDUAL NUMBER IS PENDING",
            "identifier": "7870000",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "7870000026",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MO

Sources for this page

Verify at the official NPI Registry.