Individual provider Active NPI

Daniel Duncan Meadows, PSY.D.

  • Clinical Psychologist
  • Springfield, MO
National Provider Identifier
1205038874
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2009030817 Issued in MO
Practice address
440 E Tampa St
Springfield, MO 65806-1131
Phone
(417) 831-0150
NPI assigned
Jun 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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 2009030817 MO Primary

Addresses

Primary practice location

440 E Tampa St
Springfield, MO 65806-1131

Mailing address

440 E Tampa St
Springfield, MO 65806-1131
Phone (417) 831-0150

Other identifiers 1

IdentifierTypeStateIssuer
1205038874OtherMOMISSOURI MEDICARE

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
I20101011000478 MO Practitioner - Clinical Psychologist 1254523129 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009030817MOMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Jul 1, 2014 Accepting new patients
Advocates for a Healthy Community Inc CurrentSince Oct 1, 2022 Accepting new patients
Advocates for a Healthy Community, Inc CurrentSince Oct 1, 2022 Accepting new patients

Locations

1312 E Lark St
#L
Springfield, MO 65804
Phone (417) 820-3707

440 E Tampa St
Springfield, MO 65806
Phone (417) 831-0191

Interoperability endpoints

  • Direct secure messaging: dmeadows419495@directb.mercy.net
  • Direct secure messaging: daniel.meadows.p1@direct.jordanvalley.nextgenshare.com

Organizations & group practices 3

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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1205038874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 E TAMPA ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061131",
            "telephone_number": "417-831-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E TAMPA ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061131",
            "telephone_number": "417-831-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEADOWS",
        "first_name": "DANIEL",
        "middle_name": "DUNCAN",
        "name_prefix": "Mr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2009030817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI MEDICARE",
            "identifier": "1205038874",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.