JACK TYRONE ADCOCK, DO — NPI 1669487054 (Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) in JOPLIN, MO)

CMS-1500 Box 24J / 33a • NPI

1669487054

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

207VG0400X (CMS 16)

Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor)

Box 32 Service Location & ZIP+4

3401 MCINTOSH CIR STE 200, JOPLIN, MO, 64804-3604

✓ 9-Digit EDI 837 ZIP+4 (64804-3604)

Practice Phone & Referral Fax

(417) 347-3703

Fax: (417) 347-3727

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1669487054 (JACK TYRONE ADCOCK, DO) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1669487054` (NPI-1 Individual Practitioner)
Provider / Legal Name	JACK TYRONE ADCOCK, DO
Plain-English Specialty	Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) NUCC Code: `207VG0400X` (Obstetrics & Gynecology, Gynecology)
Certifying / Licensing Body	American Board of Obstetrics and Gynecology (ABOG)
Practice Location Address	3401 MCINTOSH CIR STE 200, JOPLIN, MO, 64804-3604
Practice Telephone / Fax	Tel: (417) 347-3703 \| Fax: (417) 347-3727
Administrative Mailing Address	PO BOX 3810, JOPLIN, MO, 64803-3810
Enumeration & Last Sync	Enumerated: 2006-07-31 \| CMS Record Updated: 2024-03-18

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

3401 MCINTOSH CIR STE 200, JOPLIN, MO, 64804-3604

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Plain-English Taxonomy & CMS Crosswalk (207VG0400X)

What Does Taxonomy Code 207VG0400X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207VG0400X translates to:
"Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 16 (Physician/Obstetrics & Gynecology)
Certifying / Accrediting Authority: American Board of Obstetrics and Gynecology (ABOG)
Clinical Scope: Pregnancy confirmation and prenatal care, Pap smears and HPV vaccination, menstrual irregularities, pelvic pain, PCOS, or menopause management.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JACK TYRONE ADCOCK, DO)

Typical CPT / Diagnostic Procedures:

Comprehensive Antenatal Care, Fetal Ultrasound & Labor/Delivery
Cervical Cytology (Pap Smear), HPV Co-Testing & Colposcopy
Pelvic Ultrasound & Minimally Invasive Laparoscopic Hysterectomy/Myomectomy

Common Therapeutic Classes:

Prenatal Folic Acid, Iron & Progesterone Supplementation
Combined Oral Contraceptives, Levonorgestrel IUDs & Hormone Therapy
Fluconazole, Metronidazole & Pregnancy-Safe Beta-Lactam Antibiotics (Ampicillin)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207VG0400X` — Obstetrics & Gynecology, Gynecology Plain English: Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor)	State: MO \| License: `2001025553` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JACK TYRONE ADCOCK, DO (NPI #1669487054)