Active NPI
Carolyn Pearl Prater, D.O.
- Pediatrics Physician
- Joplin, MO
National Provider Identifier
1821203340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 106608
- Practice address
- 530 S Maiden LN
Joplin, MO 64801-3084 - Phone
- (417) 659-9100
- Fax
- (417) 659-9101
- NPI assigned
- May 10, 2007
- Last updated
- Mar 5, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 106608 | MO | Primary |
Addresses
Primary practice location
530 S Maiden LN
Joplin, MO 64801-3084
Mailing address
4301 Doniphan Dr
Neosho, MO 64850-9120
Phone (417) 451-9450
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozark Center | Current | Accepting new patients | |
| Ozark Center | Current | Accepting new patients | |
| Ozark Tri-County Health Care Consortium | Past | Accepting new patients |
Interoperability endpoints
- carolyn.prater.1@20184.direct.athenahealth.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Joplin, MO
- NPI 1790796878
-
dba Access Family Care
- Federally Qualified Health Center (FQHC)
- Carthage, MO
- NPI 1992995120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330905600000",
"number": "1821203340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 DONIPHAN DR",
"city": "NEOSHO",
"state": "MO",
"postal_code": "648509120",
"telephone_number": "417-451-9450",
"fax_number": "417-451-8903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 S MAIDEN LN",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648013084",
"telephone_number": "417-659-9100",
"fax_number": "417-659-9101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRATER",
"first_name": "CAROLYN",
"middle_name": "PEARL",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-10",
"last_updated": "2012-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "106608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joplin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.