MATT FERGUSON


Address: 4480 Bradley Dr, Joplin, MO 64804-5503
Phone: 4173174948

MATT FERGUSON (NPI# 1902426596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902426596
Entity Type Individual
Full Name MATT FERGUSON
Practice Address 4480 Bradley Dr
Joplin
MO 64804-5503
Practice Telephone 4173174948
Mailing Telephone 4173174948
Enumeration Date 2020-04-23
Last Update Date 2020-04-23
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320900000X Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities MO Residential Treatment Facilities

Office Location

Street Address 4480 BRADLEY DR
City JOPLIN
State MO
Zip Code 64804-5503

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1033718903 Lisa Jo Moore Nurse Practitioner 2623 S Main Street, Nixa, MO 64804 2020-10-22
1346859600 Centered and Connected LLC Counselor 2401 E 32nd St, Ste 10 #103, Joplin, MO 64804 2020-07-23
1649838780 Nicole Lynn Egan Social Worker 3010 Mcclelland, Joplin, MO 64804 2019-06-04
1902361652 Redings Mill Internal Care Clinic/Center 454 Redings Mill Rd, Joplin, MO 64804 2019-02-06
1447732508 Urgent Care Travel, Inc Clinic/Center 5931 E 32nd Street, Joplin, MO 64804 2018-09-05
1912488891 Karl G. Keczkemethy Dietitian, Registered 100 Mercy Way Ste 570, Joplin, MO 64804 2018-08-28
1790207546 Jacksie Short Dentist 2819 E 29th St, Joplin, MO 64804 2017-07-13
1326574625 Kristine Kwon Rowland Nurse Practitioner 100 Mercy Way Ste 320-330, Joplin, MO 64804 2017-05-05
1942735212 West R Loveland Counselor 3230 S Wisconsin St Suite H, Joplin, MO 64804 2017-04-25
1174070205 Tracy L Fry Nurse Practitioner 3333 Mcintosh Cir Ste 4, Joplin, MO 64804 2016-09-07
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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1609212596 The Arc of The Ozarks Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 4722 E 32nd St, Joplin, MO 64804-4411 2013-05-17
1013106723 Easy Living Inc. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 110 N Range Line Rd Ste 202, Joplin, MO 64801-1600 2007-10-18
1427173434 Skills Unlimited Inc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 4215 Kentucky Ave, Joplin, MO 64804-4643 2007-03-20
1740292325 Wilkinson Pharmacy, Inc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1227 E 32nd, Suite 5, Joplin, MO 64804-2904 2006-08-12
1407239171 Skillset LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2312 Annie Baxter Ave, Joplin, MO 64804-0329 2015-06-30
1225416043 Preferred Family Healthcare Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2709 W 13th St, Joplin, MO 64801-3663 2015-05-13
1952788671 C Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 420 S Pearl Ave, Suite 5, Joplin, MO 64801-2541 2015-05-01
1487778155 Jasper County Sheltered Facilities Assoc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2312 Annie Baxter Ave, Joplin, MO 64804-0329 2007-03-19
1306960075 Jasper County Sheltered Facilities Assoc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2312 Annie Baxter Ave, Joplin, MO 64804-0329 2007-03-19

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1609475516 Brandi Janelle Hickman Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 8706 Newton Ave Apt 4101, Kansas City, MO 64138-5461 2020-10-21
1154935112 Overcomers Counseling Center Inc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 17101 East 203rd St, Peculiar, MO 64078 2020-09-06
1386265965 Candace Palmer Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2405 Bowe Ln, Jefferson City, MO 65109-9116 2020-05-05
1689206211 Insight Industry LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2501 Ne Prairie Falcon Dr, Blue Springs, MO 64014-1958 2020-02-11
1598306904 Hearo Technologies LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 405 N Jefferson Ave Ste 1063, Springfield, MO 65806-1110 2019-10-07
1437790219 Darin Roark Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2628 Se Kimbrough Ln, Lees Summit, MO 64063-1082 2019-10-03
1942851399 Wyatt's Dream Center Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 205 State Highway Aa, Sikeston, MO 63801-5303 2019-09-26
1043871908 Cura Personalis, (care for The Whole Person), LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 11650 Bobwhite Road, Carthage, MO 64836 2019-06-21
1043870181 Rebuild Contracting LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1783 Possum Hollow Dr, Camdenton, MO 65020-6709 2019-06-20
1477112092 Gray Matters Alliance LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 112 W Pitman St, O Fallon, MO 63366-2819 2019-06-07
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Competitor

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City JOPLIN
Zip Code 64804

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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