DR. WILLIAM RUSSELL DETTEN D.O. NPI 1033229935

NPI Information

  • NPI: 1033229935
  • Provider Name: DR. WILLIAM RUSSELL DETTEN, D.O.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1530 E REPUBLIC RD
    SPRINGFIELD, MO
    ZIP 65804
  • Phone: (417) 269-1362

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NPI Details

DR. William Russell Detten, D.O. is a family medicine in Springfield, MO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. William Russell Detten, D.O. NPI is 1033229935. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1530 E REPUBLIC RD
SPRINGFIELD, MO
ZIP 65804-530
Phone: (417) 269-1362
Fax: (417) 269-1372

The NPI 1033229935 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • X-ray of chest, 2 views (HCPCS:71046)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Administration of pneumococcal vaccine (HCPCS:G0009)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)
  • Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment (HCPCS:G0402)

The enumeration date for this NPI number is 8/30/2006 and was last updated on 11/12/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineR4P90MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P00372128MEDICARE PIN
25716OTHERBLUE CROSS MO
3917185132MEDICARE PIN
4246778419MEDICAIDMISSOURI
5004012299MEDICARE PIN
6F29291MEDICARE UPIN
7080072355MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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