Active NPI
Rodger Eugene Moler, D.O.
- Family Medicine Physician
- Nixa, MO
National Provider Identifier
1992740179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R9565
- Practice address
- 105 S Ridgecrest
Nixa, MO 65714 - Phone
- (417) 725-8250
- Fax
- (417) 724-3185
- NPI assigned
- Jun 19, 2006
- 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 | R9565 | MO | Primary |
Addresses
Primary practice location
105 S Ridgecrest
Nixa, MO 65714
Mailing address
105 S Ridgecrest
Nixa, MO 65714
Phone (417) 725-8250
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 176410003 | Medicaid | AR | |
| 241039445 | Medicaid | MO | |
| 1992410179 | Medicaid | MO | |
| 080036692 | Other | RR MEDICARE |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R9565 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
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": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308182400000",
"number": "1992740179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 S RIDGECREST",
"city": "NIXA",
"state": "MO",
"postal_code": "65714",
"telephone_number": "417-725-8250",
"fax_number": "417-724-3185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 S RIDGECREST",
"city": "NIXA",
"state": "MO",
"postal_code": "65714",
"telephone_number": "417-725-8250",
"fax_number": "417-724-3185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLER",
"first_name": "RODGER",
"middle_name": "EUGENE",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-19",
"last_updated": "2011-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "R9565",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "176410003",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "241039445",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1992410179",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "080036692",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Nixa, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.