Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Douglas R Bishop

Individual provider Registered Nurse · NPI 1417353608

Douglas R Bishop is a Nurse Practitioner in Poplar Bluff, Missouri. Qualified in 2014, 12 years ago. Practices with Southeastern Physician Services PC, a 598-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
12
Licensed in
MO
In the registry since
2014
Specialties on file
3
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Practice location Address checks out

2865 James Blvd
Poplar Bluff, MO 63901-2803 Not confirmed with CMS for 11 years — call before visiting
Phone: (573) 776-1100
Fax: (573) 776-1107
Show map & directions

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 2014038385 (MO)
Registered Nurse Taxonomy 163W00000X · Licence 2009003804 (MO)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 2014038385 (MO)

Record details

NPI number1417353608
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 14, 2014
Last updated in NPPESNovember 14, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Southeastern Physician Services Pc — 598 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients232
Services billed 345 a service is one billed item, such as a visit, a test or a procedure
Average patient age77

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

Colleagues at Southeastern Physician Services PC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 598 clinicians in the practice; 12 are shown here.

Other providers in Poplar Bluff