Active NPI
Matthew R Marshall
- Professional Counselor
- Branson, MO
National Provider Identifier
1275815532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2011030017
- Practice address
- 1015 Hwy 248
Suite I
Branson, MO 65616-8001 - Phone
- (417) 429-1889
- NPI assigned
- Sep 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2011030017 | MO | Primary |
Addresses
Primary practice location
1015 Hwy 248
Suite I
Branson, MO 65616-8001
Mailing address
821 S 2ND St
Branson, MO 65616-3125
Phone (417) 230-5132
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011030017 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1275815532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "821 S 2ND ST",
"city": "BRANSON",
"state": "MO",
"postal_code": "656163125",
"telephone_number": "417-230-5132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 HWY 248",
"address_2": "SUITE I",
"city": "BRANSON",
"state": "MO",
"postal_code": "656168001",
"telephone_number": "417-429-1889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "MATTHEW",
"middle_name": "R",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-13",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2011030017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Branson, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.