Individual provider Active NPI

Matthew T Tompkins, LPC, NCC, EDS

  • Professional Counselor
  • Jackson, MO
National Provider Identifier
1861908337
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2017032823 Issued in MO
Practice address
810 E Jackson Blvd Ste B1
Jackson, MO 63755-2400
Phone
(573) 213-8033
NPI assigned
Dec 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2017032823 MO Primary

Addresses

Primary practice location

810 E Jackson Blvd Ste B1
Jackson, MO 63755-2400

Mailing address

810 E Jackson Blvd Ste B1
Jackson, MO 63755-2400
Phone (573) 213-8033

Other practice location 1

402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536
Phone (573) 334-1100

Other identifiers 1

IdentifierTypeStateIssuer
490055178MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sounds of Mind Counseling Mental Health CurrentSince Feb 7, 2021 Accepting new patients

Locations

810 E Jackson Blvd
Ste B1
Jackson, MO 63755
Phone (573) 213-8033

Organizations & group practices 1

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": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1861908337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 E JACKSON BLVD STE B1",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637552400",
            "telephone_number": "573-213-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E JACKSON BLVD STE B1",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637552400",
            "telephone_number": "573-213-8033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 S Silver Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Cape Girardeau",
            "state": "MO",
            "postal_code": "637037536",
            "country_code": "US",
            "telephone_number": "573-334-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMPKINS",
        "first_name": "MATTHEW",
        "middle_name": "T",
        "credential": "LPC, NCC, EDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-20",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2017032823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490055178",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.