Individual provider Active NPI

Joseph Craigmyle, M.D.

  • Emergency Medicine Physician
  • Springfield, MO
National Provider Identifier
1992792030
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
101791 Issued in MO
Practice address
1423 N Jefferson Ave
Springfield, MO 65802-1917
Phone
(417) 269-6583
Fax
(417) 269-6573
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 101791 MO Primary

Addresses

Primary practice location

1423 N Jefferson Ave
Springfield, MO 65802-1917

Mailing address

PO Box 9007
Springfield, MO 65808-9007
Phone (417) 269-6583

Other identifiers 2

IdentifierTypeStateIssuer
204700306MedicaidMO
1992792030MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040401001439 MO Practitioner - Emergency MedicinePractitioner - Vascular Surgery 1254323892 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.52 of 100Reported as group
Quality
61.64
Promoting interoperability
100
Improvement activities
40
Cost
76.77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101791MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Jun 19, 2012 Accepting new patients
Lester E. Cox Medical Centers Current Accepting new patients
Lester E Cox Medical Centers CurrentSince Mar 1, 2018 Accepting new patients
Lester E Cox Medical Centers Emergency Medicine CurrentSince Jun 19, 2012 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1001 E Primrose St
Ste 200
Springfield, MO 65807
Phone (417) 875-3275

1000 E Primrose St
Ste 360
Springfield, MO 65807
Phone (417) 269-4037

3800 S National Ave
Ste 540
Springfield, MO 65807
Phone (417) 269-6262

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

1423 N Jefferson Ave
Springfield, MO 65802
Phone (417) 269-6583

3801 S National Ave
Fl 5
Springfield, MO 65807

2021 E Independence St
Springfield, MO 65804
Phone (417) 885-1445

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

3801 S National Ave
Ste 1122
Springfield, MO 65807

Organizations & group practices 5

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1992792030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658089007",
            "telephone_number": "417-269-6583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 N JEFFERSON AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658021917",
            "telephone_number": "417-269-6583",
            "fax_number": "417-269-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIGMYLE",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "101791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204700306",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992792030",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.