Active NPI
Tristan McDonald, LMSW
- Social Worker
- Columbia, MO
National Provider Identifier
1164208500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 2023029192
- Practice address
- 3501 Berrywood Dr
Columbia, MO 65201-6584 - Phone
- (844) 853-8937
- NPI assigned
- Sep 1, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 2023029192 | MO | Primary |
Addresses
Primary practice location
3501 Berrywood Dr
Columbia, MO 65201-6584
Mailing address
1800 Community
Clinton, MO 64735-8804
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023029192 | MO | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693526400000",
"number": "1164208500",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 BERRYWOOD DR",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652016584",
"telephone_number": "844-853-8937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "TRISTAN",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-01",
"last_updated": "2023-09-01",
"certification_date": "2023-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MO",
"license": "2023029192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.