Matthew Kory Scullawl, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2006036228 Issued in MO

Practice address

213 W Olive St
Ste 101
Springfield, MO 65806-1301

Phone

(417) 862-3937

Fax

(417) 862-3936

NPI assigned

Jun 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision Clinic PCGroup PAC ID 2668404161, 14 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kory.scullawl@direct.revolutionehr.com
• Direct secure messaging: koryscullawl@vision-clinic-downtown.direct.kno2fy.com

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.

• Vision Clinic PC

  • Optometrist
  • Springfield, MO
  • NPI 1316963564
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1982631107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 W OLIVE ST",
            "address_2": "STE 101",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061301",
            "telephone_number": "417-862-3937",
            "fax_number": "417-862-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 W OLIVE ST",
            "address_2": "STE 101",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061301",
            "telephone_number": "417-862-3937",
            "fax_number": "417-862-3936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLAWL",
        "first_name": "MATTHEW",
        "middle_name": "KORY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2006036228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200066910A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendell J. Scott, MD
• Hannah Scotten
• Sally A Scrivener
• Rea S Scroggins, FNP
• Catherine Scruggs
• Meghan Seago, M.D.
• Richard A. Seagrave, MD
• Deborah Seale
• Joshua D. Seaman, MA
• Jessica Elaine Sears, MD

• Optometrist in Springfield, MO
• Providers in Springfield, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.