Individual provider Active NPI

Jonathan W Elam, CP, PSYD

  • Clinical Psychologist
  • Columbia, MO
National Provider Identifier
1104659382
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2024033737 Issued in MO
Practice address
1000 W Nifong Blvd BLDG 6
Columbia, MO 65203-5615
Phone
(844) 853-8937
NPI assigned
Aug 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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 2024033737 MO Primary

Addresses

Primary practice location

1000 W Nifong Blvd BLDG 6
Columbia, MO 65203-5615

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (844) 853-8937

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
I20250902002833 MO Practitioner - Clinical Psychologist 0143721977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Health IncGroup PAC ID 1951206754, 317 clinicians

Practice addresses (Care Compare)

1000 W Nifong Blvd BLDG 67
220B Woodrail Centre
Columbia, MO 65203-5615
Phone (888) 403-1071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc CurrentSince Jul 28, 2025 Accepting new patients
Compass Health, Inc CurrentSince Jul 28, 2025 Accepting new patients

Locations

1800 Community
#B
Clinton, MO 64735

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

1000 W Nifong Blvd
Bldg 6
Columbia, MO 65203
Phone (573) 443-7755

1000 W Nifong Blvd
Bldg 67
Columbia, MO 65203

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": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1104659382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "844-853-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W NIFONG BLVD BLDG 6",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035615",
            "telephone_number": "844-853-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAM",
        "first_name": "JONATHAN",
        "middle_name": "W",
        "credential": "CP, PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-22",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2024033737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.