NPIMap

Organization Active NPI

Ozark Health Ventures, LLC

Doing business as Ozark Neuro Rehab Center

  • Psychologist
  • Springfield, MO
National Provider Identifier
1427157999
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2006010348 Issued in MO
Legal business name
OZARK HEALTH VENTURES, LLC
Doing business as
Ozark Neuro Rehab Center
Practice address
3550 S National Ave
Suite 200
Springfield, MO 65807-7309
Phone
(417) 269-9300
Fax
(417) 269-0582
NPI assigned
Sep 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert T. Brodhead
Title
President
Phone
(417) 820-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2006010348 MO Primary

Addresses

Primary practice location

3550 S National Ave
Suite 200
Springfield, MO 65807-7309

Mailing address

3550 S National Ave
Suite 200
Springfield, MO 65807-7309
Phone (417) 269-9300

Other names 1

  • Ozark Neuro Rehab Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080304000146 MO Part B Supplier - Clinic/Group Practice 1658321377 Receives reassigned benefits from 3 practitioners
Practice locations: Springfield, MO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3550 S National Ave
Ste 200
Springfield, MO 65807
Phone (417) 269-9300

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427157999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 S NATIONAL AVE",
            "address_2": "SUITE 200",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077309",
            "telephone_number": "417-269-9300",
            "fax_number": "417-269-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 S NATIONAL AVE",
            "address_2": "SUITE 200",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077309",
            "telephone_number": "417-269-9300",
            "fax_number": "417-269-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZARK HEALTH VENTURES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRODHEAD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-820-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2006010348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ozark Neuro Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.