Individual provider Active NPI

Michael Martin Luther Krownapple, PSY.D.

  • Clinical Psychologist
  • Farmington, MO
National Provider Identifier
1568779189
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2008031123 Issued in MO
Practice address
1010 W Columbia St
Farmington, MO 63640-2902
Phone
(573) 218-6040
NPI assigned
Sep 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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 2008031123 MO Primary

Addresses

Primary practice location

1010 W Columbia St
Farmington, MO 63640-2902

Mailing address

2109A Russell Blvd
Saint Louis, MO 63104-2606
Phone (314) 566-3391

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
I20111118000486 MO Practitioner - Clinical Psychologist 8820262330 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deer Oaks Mental Health Associates PCGroup PAC ID 2264337013, 55 clinicians

Practice addresses (Care Compare)

1531 Nebraska St
Tiffany Heights
Mound City, MO 64470-1610
Phone (660) 442-3146

Merit-based Incentive Payment System (MIPS)

Final score
91.16 of 100Reported as group
Quality
80.99
Improvement activities
40
Cost
72.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Psychiatric Services Inc CurrentSince Sep 1, 2016 Accepting new patients
Creative Change, LLC Clinical CurrentSince Jan 15, 2013 Accepting new patients
Deer Oaks Mental Health Associates PC Clinical CurrentSince Nov 2, 2011 Accepting new patients
Advanced Psychiatric Services Past Accepting new patients
Spiritual Family Counseling, LLC Past Accepting new patients

Locations

1300 County Farm Rd
Cassville, MO 65625
Phone (417) 847-3386

807 Collins Dr
Festus, MO 63028
Phone (636) 931-4206

4741 Central St
Kansas City, MO 64112
Phone (816) 265-2551

1531 Nebraska St
Mound City, MO 64470
Phone (660) 442-3146

50 Crestwood Executive Ctr
Ste 435
Saint Louis, MO 63126
Phone (314) 254-3455

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

Organizations & group practices 5

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": "1283385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1568779189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109A RUSSELL BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631042606",
            "telephone_number": "314-566-3391",
            "fax_number": "573-218-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W COLUMBIA ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636402902",
            "telephone_number": "573-218-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROWNAPPLE",
        "first_name": "MICHAEL",
        "middle_name": "MARTIN LUTHER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-02",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2008031123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

Verify at the official NPI Registry.