Active NPI
Caleb Eggleston
- Counselor
- Republic, MO
National Provider Identifier
1295572360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 2024018840
- Practice address
- 283 US Highway 60 W
Republic, MO 65738-1432 - Phone
- (417) 216-6189
- NPI assigned
- Jul 15, 2024
- Last updated
- Jul 15, 2024
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 2024018840 | MO | Primary |
Addresses
Primary practice location
283 US Highway 60 W
Republic, MO 65738-1432
Mailing address
2005 S 22ND Ave
Ozark, MO 65721-8731
Phone (417) 689-3183
Other practice location 1
865 N Nicholas Rd
Nixa, MO 65714-7678
Phone (417) 689-3183
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 |
|---|---|---|---|
| 2024018840 | MO | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1295572360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2005 S 22ND AVE",
"city": "OZARK",
"state": "MO",
"postal_code": "657218731",
"telephone_number": "417-689-3183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "283 US HIGHWAY 60 W",
"city": "REPUBLIC",
"state": "MO",
"postal_code": "657381432",
"telephone_number": "417-216-6189"
}
],
"practiceLocations": [
{
"address_1": "865 N Nicholas Rd",
"address_purpose": "LOCATION",
"city": "Nixa",
"state": "MO",
"postal_code": "657147678",
"country_code": "US",
"telephone_number": "417-689-3183",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EGGLESTON",
"first_name": "CALEB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-15",
"last_updated": "2024-07-15",
"certification_date": "2024-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor",
"state": "MO",
"license": "2024018840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Republic, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.