Individual provider Active NPI

Matthew Chatman, FNP

  • Family Nurse Practitioner
  • Poplar Bluff, MO
National Provider Identifier
1801346515
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016025962 Issued in MO
Practice address
2651 Shelby Rd
Poplar Bluff, MO 63901-2387
Phone
(573) 843-8380
Fax
(573) 843-8381
NPI assigned
Oct 5, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016025962 MO Primary

Addresses

Primary practice location

2651 Shelby Rd
Poplar Bluff, MO 63901-2387

Mailing address

PO Box 1308
Poplar Bluff, MO 63902-1308
Phone (573) 843-8380

Other practice location 1

1207 N Douglass St
Malden, MO 63863-1351
Phone (573) 276-3884

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170118002785 MO Practitioner - Nurse Practitioner 2365724812 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Louis Medical Associates LLCGroup PAC ID 5193185601, 11 clinicians

Practice addresses (Care Compare)

2651 Shelby Rd
Poplar Bluff, MO 63901-2387
Phone (573) 843-8380

Merit-based Incentive Payment System (MIPS)

Final score
50.12 of 100Reported as group
Quality
2.83
Improvement activities
40
Cost
82.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri HB Medical Services, LLC CurrentSince May 6, 2024 Accepting new patients
St Louis Medical Associates LLC CurrentSince Sep 1, 2023 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

2651 Shelby Rd
Ste 100
Poplar Bluff, MO 63901

2651 Shelby Rd
Poplar Bluff, MO 63901
Phone (573) 843-8380

3100 Oak Grove Rd
Rombauer, MO 63901
Phone (573) 776-2000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1801346515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1308",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639021308",
            "telephone_number": "573-843-8380",
            "fax_number": "573-843-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 SHELBY RD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012387",
            "telephone_number": "573-843-8380",
            "fax_number": "573-843-8381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1207 N Douglass St",
            "address_purpose": "LOCATION",
            "city": "Malden",
            "state": "MO",
            "postal_code": "638631351",
            "country_code": "US",
            "telephone_number": "573-276-3884",
            "fax_number": "573-276-3885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHATMAN",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-05",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016025962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.