Midwest Neuropsychology and Behavioral Health, LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2013020719 Issued in MO

Legal business name

MIDWEST NEUROPSYCHOLOGY AND BEHAVIORAL HEALTH, LLC

Practice address

1864 S Kentwood Ave
Springfield, MO 65804-2323

Phone

(417) 880-6838

Fax

(417) 374-0074

NPI assigned

Aug 12, 2013

Last updated

May 24, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Grant Jones, PSY.D.NPI 1023459971

Title

Neuropsychologist

Phone

(417) 880-6838

Specialties & licenses 3

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Grant Jones, PSY.D.

  • Clinical Neuropsychologist
  • Springfield, MO
  • NPI 1023459971
  Authorized official Same address or phone
• Ernest Grant Jones

  • Psychologist
  • Springfield, MO
  • NPI 1831370592
  NPD (past)

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

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1669805826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1864 S KENTWOOD AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042323",
            "telephone_number": "417-880-6838",
            "fax_number": "417-374-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1864 S KENTWOOD AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042323",
            "telephone_number": "417-880-6838",
            "fax_number": "417-374-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST NEUROPSYCHOLOGY AND BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-12",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "417-880-6838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MO",
            "license": "2013020719",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2013020719",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2013015422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mark S. Mikesch, CRNA

• Clinical Neuropsychologist in Springfield, MO
• Providers in Springfield, MO by specialty
• Clinical Neuropsychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.