Individual provider Active NPI

Philip M Swope, PSYD, LP

  • Clinical Psychologist
  • Springfield, MO
National Provider Identifier
1063934404
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2018030708 Issued in MO
Practice address
1300 E Bradford Pkwy
Springfield, MO 65804
Phone
(417) 761-5000
Fax
(417) 761-5011
NPI assigned
Jul 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2018030708 MO Primary

Addresses

Primary practice location

1300 E Bradford Pkwy
Springfield, MO 65804

Mailing address

1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone (417) 761-5000

Other identifiers 1

IdentifierTypeStateIssuer
490045118MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190521003524 MO Practitioner - Clinical Psychologist 1850634585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, 1,121 clinicians

Practice addresses (Care Compare)

1312 E Lark St
Behavioral Health Lark
Springfield, MO 65804-7351
Phone (417) 820-3707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Jul 29, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jul 29, 2024 Accepting new patients

Locations

1312 E Lark St
Springfield, MO 65804
Phone (417) 820-3707

1312 E Lark St
#L
Springfield, MO 65804
Phone (417) 820-3707

Interoperability endpoints

  • Direct secure messaging: philip.swope.p1@direct.jordanvalley.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1063934404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65804",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWOPE",
        "first_name": "PHILIP",
        "middle_name": "M",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-07",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2018030708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490045118",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.