Individual provider Active NPI

Caleb Coulter

  • Clinical Nurse Specialist
  • Joplin, MO
National Provider Identifier
1124979679
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
2026012438 Issued in MO
Practice address
100 Mercy Way
Joplin, MO 64804-4524
Phone
(417) 781-2727
NPI assigned
Feb 9, 2026
Last updated
Mar 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 2026012438 MO Primary
Registered Nurse 163W00000X 2017019077 MO

Addresses

Primary practice location

100 Mercy Way
Joplin, MO 64804-4524

Mailing address

100 Mercy Way
Joplin, MO 64804-4524
Phone (417) 781-2727

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260415001984 MO Practitioner - Certified Clinical Nurse Specialist (CNS) 9739655077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
University of Missouri, Columbia School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians

Practice addresses (Care Compare)

100 Mercy Way
Joplin, MO 64804-4524
Phone (417) 556-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017019077MOMDRegistered Nurse
2026012438MOMDClinical Nurse Specialist

Organizations & group practices 1

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": "1770595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1124979679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-781-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MERCY WAY",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044524",
            "telephone_number": "417-781-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTER",
        "first_name": "CALEB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-09",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "MO",
            "license": "2026012438",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2017019077",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.