Individual provider Active NPI

Phillip M Hornbostel, MD

  • Surgery Physician
  • Saint Joseph, MO
National Provider Identifier
1992797963
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
R9A37 Issued in MO
Practice address
802 N Riverside Rd Ste 220
Saint Joseph, MO 64507-2509
Phone
(816) 271-6155
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X R9A37 MO Primary

Addresses

Primary practice location

802 N Riverside Rd Ste 220
Saint Joseph, MO 64507-2509

Mailing address

802 N Riverside Rd Ste 220
Saint Joseph, MO 64507-2509
Phone (816) 271-6155

Other practice location 1

3300 W 10th St
Sedalia, MO 65301-2111
Phone (660) 827-0423

Other practice location 2

3300 W 10th St
Sedalia, MO 65301-2111
Phone (660) 827-0423

Other identifiers 1

IdentifierTypeStateIssuer
201412020MedicaidMO

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 Medicine

Interoperability endpoints

  • Direct secure messaging: phillip.hornbostel@direct.mymlc.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1992797963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 N RIVERSIDE RD STE 220",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645072509",
            "telephone_number": "816-271-6155",
            "fax_number": "660-827-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 N RIVERSIDE RD STE 220",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645072509",
            "telephone_number": "816-271-6155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Sedalia",
            "state": "MO",
            "postal_code": "653012111",
            "country_code": "US",
            "telephone_number": "660-827-0423",
            "fax_number": "660-827-5510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Sedalia",
            "state": "MO",
            "postal_code": "653012111",
            "country_code": "US",
            "telephone_number": "660-827-0423",
            "fax_number": "660-827-5510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORNBOSTEL",
        "first_name": "PHILLIP",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "R9A37",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201412020",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.