Active NPI
Matthew Ty Reddick, DO
- Internal Medicine Physician
- Joplin, MO
National Provider Identifier
1194393249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 2024016785
- Practice address
- 100 Mercy Way
Joplin, MO 64804-4524 - Phone
- (417) 781-2727
- NPI assigned
- Jun 15, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 2024016785 | MO | Primary |
Addresses
Primary practice location
100 Mercy Way
Joplin, MO 64804-4524
Mailing address
1400 E Downing St
Tahlequah, OK 74464-3324
Phone (918) 456-0641
Other practice location 1
1400 E Downing St
Tahlequah, OK 74464-3324
Phone (918) 456-0641
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Mercy Way
Mercy Clinic Joplin Hospitalists
Joplin, MO 64804-4524
Phone (417) 556-3754
Hospital & facility affiliations
- Mercy Hospital Joplin
- Mercy Hospital Carthage
- Mercy Hospital Springfield
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Joplin LLC | Internal Medicine | Current | Accepting new patients |
| Mercy Hospital Joplin | Past | Accepting new patients |
Locations
3125 Dr Russell Smith Way
Carthage, MO 64836
Phone (417) 358-8121
94 Main St
Cassville, MO 65625
Phone (417) 782-7722
100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300
Interoperability endpoints
- mreddick912599@ahs.direct-ci.com
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.
-
- General Acute Care Hospital
- Joplin, MO
- NPI 1700112745
Hospital & facility affiliations 12
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Carthage, MO
- NPI 1003201955
-
- General Acute Care Hospital
- Carthage, MO
- NPI 1396012753
-
- General Acute Care Hospital
- Joplin, MO
- NPI 1700112745
-
- General Acute Care Hospital
- Springfield, MO
- NPI 1578504056
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721606400000",
"number": "1194393249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 E DOWNING ST",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744643324",
"telephone_number": "918-456-0641"
},
{
"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": [
{
"address_1": "1400 E Downing St",
"address_purpose": "LOCATION",
"city": "Tahlequah",
"state": "OK",
"postal_code": "744643324",
"country_code": "US",
"telephone_number": "918-456-0641",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REDDICK",
"first_name": "MATTHEW",
"middle_name": "TY",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-15",
"last_updated": "2024-07-22",
"certification_date": "2024-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2024016785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joplin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.