Individual provider Active NPI

Raymond Dean Paxton, LCSW

  • Clinical Social Worker
  • Poplar Bluff, MO
National Provider Identifier
1386685659
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2002013125 Issued in MO
Practice address
1500 N Westwood Blvd
Poplar Bluff, MO 63901-3318
Phone
(573) 778-4439
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2002013125 MO Primary

Addresses

Primary practice location

1500 N Westwood Blvd
Poplar Bluff, MO 63901-3318

Mailing address

1500 N Westwood Blvd
Poplar Bluff, MO 63901-3318
Phone (573) 778-4439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170905003565 SC Practitioner - Clinical Social Worker 9234402744 Reassigns benefits to 1 organization
I20241223001399 MO Practitioner - Clinical Social Worker 9234402744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Health IncGroup PAC ID 9234525098, 213 clinicians

Practice addresses (Care Compare)

Saint Louis, MO 63133
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2002013125MOMDClinical Social Worker
013125MOMDGeneral Practice Dentistry
11535SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Health, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Mynd Health LLC Past Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

6907 Page Ave
Saint Louis, MO 63133
Phone (317) 480-0421

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1386685659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013318",
            "telephone_number": "573-778-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013318",
            "telephone_number": "573-778-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAXTON",
        "first_name": "RAYMOND",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2002013125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.