Individual provider Active NPI

Matthew Marshall, FNP

  • Nurse Practitioner
  • Branson, MO
National Provider Identifier
1073925319
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2025017576 Issued in MO
Practice address
1065 State Highway 248
Branson, MO 65616-8398
Phone
(417) 332-3639
Fax
(417) 332-3639
NPI assigned
May 21, 2014
Last updated
Aug 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP5594 AZ
Nurse Practitioner 363L00000X 2025017576 MO Primary

Addresses

Primary practice location

1065 State Highway 248
Branson, MO 65616-8398

Mailing address

1065 State Highway 248
Branson, MO 65616-8398
Phone (417) 332-3639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140722000934 AZ Practitioner - Nurse Practitioner 8527284884 Reassigns benefits to 1 organization
I20260613000079 MO Practitioner - Nurse Practitioner 8527284884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolyn Clark FNP LLCGroup PAC ID 9638480080, 3 clinicians
Healing Arts Center L.L.C.Group PAC ID 4789620261, 66 clinicians

Practice addresses (Care Compare)

1065 State Hwy 248
Branson, MO 65616-8398
Phone (417) 332-3639

225 Violyn Dr
Branson, MO 65616-8128
Phone 4173346660402

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2025017576MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Pain & Treatment Center CurrentSince Feb 1, 2021 Accepting new patients
Compass Medical Center Safford PLLC CurrentSince Mar 15, 2019 Accepting new patients
Audiology, Inc. CurrentSince Sep 27, 2021 Accepting new patients
Carolyn Clark FNP LLC Family Past Accepting new patients
Canyonlands Community Health Care Past Accepting new patients

Locations

5505 W Chandler Blvd
Ste 11
Chandler, AZ 85226
Phone (480) 659-2571

823 N San Francisco St
Ste A
Flagstaff, AZ 86001
Phone (480) 213-8488

4830 Highway 260
Ste 102
Lakeside, AZ 85929
Phone (520) 244-0089

11811 N Tatum Blvd
Ste 303167
Phoenix, AZ 85028

1491 W Thatcher Blvd
Ste 107
Safford, AZ 85546
Phone (928) 428-1613

1765 S 20th Ave
Safford, AZ 85546
Phone (928) 424-1600

3401 S White Mountain Rd
Ste A
Show Low, AZ 85901
Phone (520) 244-0089

610 E Baseline Rd
Tempe, AZ 85283
Phone (480) 969-0405

Organizations & group practices 6

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1073925319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 STATE HIGHWAY 248",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656168398",
            "telephone_number": "417-332-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 STATE HIGHWAY 248",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656168398",
            "telephone_number": "417-332-3639",
            "fax_number": "417-332-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-21",
        "last_updated": "2025-08-14",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP5594",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2025017576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

Verify at the official NPI Registry.