Individual provider Active NPI

Michelle Lea Beisner-Whitmire, PSY. D., LP

  • Clinical Psychologist
  • Springfield, MO
National Provider Identifier
1487725768
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2006034119 Issued in MO
Practice address
1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone
(417) 761-5000
Fax
(417) 761-5011
NPI assigned
Nov 10, 2006
Last updated
Mar 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2006034119 MO Primary

Addresses

Primary practice location

1300 E Bradford Pkwy
Springfield, MO 65804-4264

Mailing address

1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone (417) 761-5000

Other practice location 1

530 E 34th St
Suite 100
Joplin, MO 64804-3924
Phone (417) 347-7530

Other identifiers 1

IdentifierTypeStateIssuer
497212902MedicaidMO

Other names 1

  • Dr. Michelle Lea Beisner-Whitmire Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070717000157 MO Practitioner - Clinical Psychologist 2567562770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Burrell IncGroup PAC ID 4486548625, 217 clinicians

Practice addresses (Care Compare)

1300 E Bradford Pkwy
Springfield, MO 65804-4264

210 N Williams
Burrell Behavioral Health
Moberly, MO 65720-1583
Phone (660) 263-7651

2885 W Battlefield St
Springfield, MO 65807-3952
Phone (417) 761-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Burrell, Inc. CurrentSince Aug 28, 2015 Accepting new patients
Burrell, Inc. CurrentSince Aug 28, 2015 Accepting new patients
Ozark Center Past Accepting new patients

Locations

1300 E Bradford Pkwy
Springfield, MO 65804
Phone (417) 269-5400

1300 E Bradford Pkwy
#H
Springfield, MO 65804

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1487725768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 E 34th St",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648043924",
            "country_code": "US",
            "telephone_number": "417-347-7530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEISNER-WHITMIRE",
        "first_name": "MICHELLE",
        "middle_name": "LEA",
        "credential": "PSY. D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2006034119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497212902",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "BEISNER-WHITMIRE",
            "middle_name": "LEA",
            "prefix": "DR.",
            "credential": "PSY. D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.