Individual provider Active NPI

Matthew Duane Sams, D.C.

  • Chiropractor
  • Branson, MO
National Provider Identifier
1457434367
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006810 Issued in MO
Practice address
225 Violyn Dr
Branson, MO 65616-8128
Phone
(417) 334-6660
Fax
(417) 334-6661
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 006810 MO Primary

Addresses

Primary practice location

225 Violyn Dr
Branson, MO 65616-8128

Mailing address

225 Violyn Dr
Branson, MO 65616-8128
Phone (417) 334-6660

Other identifiers 3

IdentifierTypeStateIssuer
128937OtherMOBLUE CROSS BLUE SHIELD
230074281MedicaidMO
350056657OtherMORAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040824000497 MO Practitioner - Chiropractic 1254304256 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Arts Center L.L.C. Chiropractor CurrentSince Aug 23, 1999 Accepting new patients

Locations

225 Violyn Dr
Branson, MO 65616
Phone (417) 334-6660

Organizations & group practices 1

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1457434367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 VIOLYN DR",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656168128",
            "telephone_number": "417-334-6660",
            "fax_number": "417-334-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 VIOLYN DR",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656168128",
            "telephone_number": "417-334-6660",
            "fax_number": "417-334-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMS",
        "first_name": "MATTHEW",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "006810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "128937",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230074281",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350056657",
            "state": "MO"
        }
    ],
    "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 May 21, 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.