Individual provider Active NPI

Matthew Austin Brown, MD

  • Family Medicine Physician
  • Mountain Grove, MO
National Provider Identifier
1174779300
Registry record updated Apr 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2011010536 Issued in MO
Practice address
9100 13TH Rd
Mountain Grove, MO 65711-2387
Phone
(417) 260-4150
NPI assigned
Aug 7, 2008
Last updated
Apr 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2011010536 MO Primary

Addresses

Primary practice location

9100 13TH Rd
Mountain Grove, MO 65711-2387

Mailing address

9100 13TH Rd
Mountain Grove, MO 65711-2387
Phone (417) 260-4150

Other identifiers 5

IdentifierTypeStateIssuer
431560263OtherMOTRICARE
26D0889777OtherMOCLIA
P00985958OtherMORR MCR
205648306MedicaidMO
1174779300MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110829000344 MO Practitioner - Family Practice 6709056807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Baylor College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

504 W Broadway Ave
Missouri Ozarks Community Health
Ava, MO 65608-1359
Phone (417) 683-5739

PO Box
Suite 1359
Ava, MO 65608-1359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2011010536MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas County Public Health Services Group, Inc. CurrentSince May 29, 2025 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Douglas County Public Health Services Group, Inc. Past Accepting new patients
Texas County Memorial Hospital Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

804 N Highway 5
Mansfield, MO 65704
Phone (417) 924-8809

Interoperability endpoints

  • Direct secure messaging: mbrown208370@directb.mercy.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713571200000",
    "number": "1174779300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 13TH RD",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657112387",
            "telephone_number": "417-260-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 13TH RD",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657112387",
            "telephone_number": "417-260-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MATTHEW",
        "middle_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-07",
        "last_updated": "2024-04-20",
        "certification_date": "2024-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2011010536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431560263",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "26D0889777",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00985958",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205648306",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174779300",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Grove, MO

Sources for this page

Verify at the official NPI Registry.