Master'S Ranch Christian Academy

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

MASTER'S RANCH CHRISTIAN ACADEMY

Practice address

287 County Road 275
Myrtle, MO 65778-8341

Phone

(417) 264-6040

NPI assigned

Aug 24, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Tombley, LPCNPI 1932511177

Title

Chief Executive Officer

Phone

(417) 274-0469

Specialties & licenses 1

Addresses

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Scott Tombley, LPC

  • Professional Counselor
  • Pomona, MO
  • NPI 1932511177
  NPD Authorized official
• Adriane Cassandra Deckard, RN, BSN

  • School Registered Nurse
  • Myrtle, MO
  • NPI 1467237719
  NPD
• Shannon Hamilton, LPC

  • Professional Counselor
  • West Plains, MO
  • NPI 1306358387
  NPD (past)
• Zachary Nelson, LPC

  • Professional Counselor
  • West Plains, MO
  • NPI 1033006978
  NPD (past)
• Mark L Sullivan, LPC

  • Professional Counselor
  • West Plains, MO
  • NPI 1295260347
  NPD (past)

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1699559138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 709",
            "city": "MYRTLE",
            "state": "MO",
            "postal_code": "657780709",
            "telephone_number": "417-264-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 COUNTY ROAD 275",
            "city": "MYRTLE",
            "state": "MO",
            "postal_code": "657788341",
            "telephone_number": "417-264-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASTER'S RANCH CHRISTIAN ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "TOMBLEY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "417-274-0469",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Sue Collins
• Couch School District R-I
• Adriane Cassandra Deckard, RN, BSN

• Emotionally Disturbed Childrens' Residential Treatment Facility in Myrtle, MO
• Providers in Myrtle, MO by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.