Individual provider Active NPI

William Joseph Klontz, MD

  • Psychiatry Physician
  • Joplin, MO
National Provider Identifier
1922001635
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
R4D32 Issued in MO
Practice address
5615 W 32ND St
Joplin, MO 64804-8161
Phone
(417) 627-8400
Fax
(417) 623-1787
NPI assigned
May 27, 2005
Last updated
Mar 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X R4D32 MO Primary

Addresses

Primary practice location

5615 W 32ND St
Joplin, MO 64804-8161

Mailing address

4119 Woodcrest CT
Joplin, MO 64804-4567
Phone (417) 627-8400

Other identifiers 3

IdentifierTypeStateIssuer
201882701MedicaidMO
100081340FMedicaidKS
100197560AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050411001249 KS Practitioner - Neuropsychiatry 8628015781 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neuropsychiatry
Education
University of Kansas School of Med (KC/Wich/Sal), 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crawford County Mental Health CenterGroup PAC ID 3072955616, 13 clinicians

Practice addresses (Care Compare)

911 E Centennial Dr
Crawford County Mental Health
Pittsburg, KS 66762-6601
Phone (620) 231-5130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Spring River Mental Health & Wellness, Inc. CurrentSince Dec 6, 1985 Accepting new patients
Spring River Mental Health and Wellness Inc CurrentSince Dec 6, 1985 Accepting new patients
Crawford County Mental Health Center CurrentSince Apr 19, 2024 Accepting new patients
Sjmgroup Past Accepting new patients

Locations

201 W Walnut St
Columbus, KS 66725
Phone (620) 429-1860

911 E Centennial Dr
Pittsburg, KS 66762
Phone (620) 338-7282

6610 SE Quakervale Rd
Riverton, KS 66770
Phone (620) 848-2300

Interoperability endpoints

  • Direct secure messaging: william.klontz@khindirect.org
  • Direct secure messaging: wklontz192243@directb.mercy.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1922001635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4119 WOODCREST CT",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648044567",
            "telephone_number": "417-627-8400",
            "fax_number": "417-623-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 W 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648048161",
            "telephone_number": "417-627-8400",
            "fax_number": "417-623-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLONTZ",
        "first_name": "WILLIAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "R4D32",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201882701",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100081340F",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100197560A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.