Individual provider Active NPI

Timmey M McClure Jr., LPC

  • Mental Health Counselor
  • Dodge City, KS
National Provider Identifier
1083247118
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC3558 Issued in KS
Practice address
236 San Jose Room 125 East
Dodge City, KS 67801-2720
Phone
(620) 408-4728
NPI assigned
Feb 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC3558 KS Primary

Addresses

Primary practice location

236 San Jose Room 125 East
Dodge City, KS 67801-2720

Mailing address

3011 Anna Ave
Dodge City, KS 67801-6519
Phone (620) 408-4728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20241010000814 KS Practitioner - Mental Health Counselor 9032641451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Behavioral HealthGroup PAC ID 1355323122, 29 clinicians

Practice addresses (Care Compare)

506 Ave L
Dodge City, KS 67801-5319
Phone (620) 227-8566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC3558KSMDMental Health Counselor
3558KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Behavioral Health CurrentSince Sep 3, 2024 Accepting new patients
Compass Behavioral Health PastSince Jun 4, 2023 Accepting new patients

Locations

506 Avenue L
Dodge City, KS 67801
Phone (620) 227-8566

1111 E Spruce St
Garden City, KS 67846
Phone (620) 276-7689

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": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1083247118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 ANNA AVE",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678016519",
            "telephone_number": "620-408-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 SAN JOSE ROOM 125 EAST",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678012720",
            "telephone_number": "620-408-4728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "TIMMEY",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KS",
            "license": "LPC3558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodge City, KS

Sources for this page

Verify at the official NPI Registry.