Active NPI
Linda D. Magruder, LPC
- Professional Counselor
- Poplar Bluff, MO
National Provider Identifier
1467439711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2000168791
- Practice address
- 101 S Main St
Poplar Bluff, MO 63901-5843 - Phone
- (573) 686-5090
- Fax
- (573) 785-4104
- NPI assigned
- Dec 28, 2005
- Sex
- Female
- Sole proprietor
- No
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 | 2000168791 | MO | Primary |
Addresses
Primary practice location
101 S Main St
Poplar Bluff, MO 63901-5843
Mailing address
101 South Main
Poplar Bluff, MO 63901-5202
Phone (573) 686-5090
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 495097016 | Medicaid | MO | |
| 430956146 | Other | MO | TRICARE |
| 685831 | Other | MO | HEALTHLINK |
| 175128 | Other | MO | BLUE CROSS BLUE SHIELD |
| 2104426 | Other | MO | CIGNA |
| 430956146 | Other | MO | MH NET AND UNITY EAP |
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 |
|---|---|---|---|
| 2000168791 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505692800000",
"number": "1467439711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 SOUTH MAIN",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639015202",
"telephone_number": "573-686-5090",
"fax_number": "573-785-4104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S MAIN ST",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639015843",
"telephone_number": "573-686-5090",
"fax_number": "573-785-4104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGRUDER",
"first_name": "LINDA",
"middle_name": "D.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-28",
"last_updated": "2017-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2000168791",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "495097016",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "430956146",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "685831",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "175128",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2104426",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MH NET AND UNITY EAP",
"identifier": "430956146",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Poplar Bluff, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.