Individual provider Active NPI

Jerry Ronnie Harper, LPC

  • Professional Counselor
  • West Plains, MO
National Provider Identifier
1487851887
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2003022742 Issued in MO
Practice address
1211 Porter Wagoner Blvd # 23
West Plains, MO 65775-1826
Phone
(417) 257-6762
NPI assigned
Jun 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2003022742 MO Primary

Addresses

Primary practice location

1211 Porter Wagoner Blvd # 23
West Plains, MO 65775-1826

Mailing address

PO Box 1102
West Plains, MO 65775-1102
Phone (417) 293-0134

Other identifiers 1

IdentifierTypeStateIssuer
496107004MedicaidMO

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
I20231218003053 MO Practitioner - Mental Health Counselor 3971952847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ozarks Medical CenterGroup PAC ID 3870491863, 166 clinicians

Practice addresses (Care Compare)

1211 Porter Wagoner Blvd
Suite 23
West Plains, MO 65775-1826
Phone 41725767623010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Current Accepting new patients
Ozarks Medical Center CurrentSince Jan 1, 2024 Accepting new patients
Ozarks Medical Center CurrentSince Jan 1, 2024 Accepting new patients

Locations

1211 Porter Wagoner Blvd
Ste 23
West Plains, MO 65775
Phone (417) 257-6762

1211 Porter Wagoner Blvd
Bldg 23
West Plains, MO 65775

1211 Porter Wagoner Blvd
#23
West Plains, MO 65775
Phone 4172576762 ext. 4140

1100 N Kentucky Ave
West Plains, MO 65775
Phone (417) 257-5959

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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1487851887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1102",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751102",
            "telephone_number": "417-293-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 PORTER WAGONER BLVD # 23",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751826",
            "telephone_number": "417-257-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARPER",
        "first_name": "JERRY",
        "middle_name": "RONNIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2003022742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "496107004",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

Verify at the official NPI Registry.