1. Home
  2. Directory
  3. Missouri
  4. Maryville
  5. Surgery
  6. NPI Profile

JACK L FOREST D.O.
NPI 1679560775
Surgery in Maryville, MO

Active since October 04, 2005PECOS EnrolledAccepts Medicare Assignment
2016 S MAIN ST, MARYVILLE, MO 64468(660) 562-2600(660) 562-7911 Get Directions Write a Review

NPPES record last updated: January 6, 2017. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jack L Forest D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK L FOREST D.O. (NPI 1679560775) is an individual surgery provider in Maryville, Missouri, licensed in Virginia (049972) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1990).

NPPES Registry Identity

NPI1679560775
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameJACK L FORESTCredential: D.O.
Location Address2016 S MAIN STMaryville, MO 64468-2655
Mailing Address114 E South Hills DrMaryville, MO 64468-2659 · (660) 562-2600 · Fax (660) 562-7911
Phone(660) 562-2600
Fax(660) 562-7911
Sole ProprietorNo
Medical School CMSOtherGraduated 1990
Enumeration DateOctober 4, 2005
Last NPPES UpdateJanuary 6, 2017
✔ NPI 1679560775 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in VA · 049972
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
2016 S MAIN ST, Maryville, MO 64468
Open in Google Maps ↗

Other Identifiers 4

OtherC09633VA · Group Ptan
Medicare UPING17430
OtherC06695VA · Group Ptan
Medicaid7313519VA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jack L Forest D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547244287
PECOS Enrollment IDI20230425002668
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Jack Forest reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fannin County Hospital Autority
459 mi
Foot & Ankle Surgery
580 DESHONG DR
Paris, TX 75460
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Fannin County Hospital Authority
  • 3 clinicians in this Medicare group
NPI 1215438601 (903) 706-5035
Vohra Post Acute Care Physicians Of Texas, PLLC
517 mi
Family Medicine
17218 PRESTON RD STE 2000
Dallas, TX 75252
  • Reassigned Medicare billing, Texas enrollment
  • 107 clinicians in this Medicare group
NPI 1821424789 (877) 866-7123

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 64468 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$65.71 typical visit price
range $16.30 – $131.05
Typical copayment $16.42 (range $4.07 – $32.76)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MIKAILA WALLACE DO
Family Medicine
2016 S MAIN ST
MARYVILLE, MO 64468
Nodaway County (660) 562-2525
DR. SALLY A. BOMAR M.D.
Family Medicine
2016 S MAIN ST
MARYVILLE, MO 64468
Nodaway County (660) 562-2525
DR. JAMES E. BRADLEY M.D.
Surgery
2016 S MAIN ST
MARYVILLE, MO 64468
Nodaway County (660) 562-2525
CLAIRE CHRISTINE GREGSON RN
Nurse Practitioner (Family)
2016 S MAIN ST
MARYVILLE, MO 64468
Nodaway County (660) 562-2600
SHELLIE KATHLEEN FARIS MD
Surgery
2016 S MAIN ST
MARYVILLE, MO 64468
Nodaway County (660) 562-2525
MOSAIC MEDICAL CENTER - MARYVILLE
Specialist
2016 S MAIN ST
MARYVILLE, MO 64468
Nodaway County (660) 562-2525
MIRANDA MARIE FLOYD AGACNP
Nurse Practitioner (Gerontology)
2016 S MAIN ST
MARYVILLE, MO 64468
Nodaway County (660) 562-7999
DR. BRIAN D. GOLIGHTLY M.D.
Family Medicine
2016 S MAIN ST
MARYVILLE, MO 64468
Nodaway County (660) 562-2525

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Forest's NPI number?

The NPI number for Jack Forest is 1679560775. It was assigned to this individual provider in the NPPES registry on October 4, 2005.

Where is Jack Forest located?

Jack Forest practices at 2016 S Main St, Maryville, MO 64468. The listed phone number is (660) 562-2600.

What is Jack Forest's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Jack Forest enrolled in Medicare?

Yes. Jack Forest is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jack Forest's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jack Forest reassigns Medicare benefits to 2 organizations: Fannin County Hospital Autority (Paris, TX) and Vohra Post Acute Care Physicians Of Texas, PLLC (Dallas, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Forest's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jack Forest accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Jack Forest as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Forest was last updated on January 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.