MATT HAVENS (NPI# 1992912216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992912216 |
| Entity Type | Individual |
| Full Name | MATT HAVENS |
| Credential | MSW LCSW, MS PA-C |
| Practice Address |
1300 N Oakland Ave Suite A Bolivar MO 65613-3018 |
| Mailing Address |
1500 N Oakland Ave Bolivar MO 65613-3011 |
| Practice Telephone | 4173267676 |
| Practice Fax Number | 4173263939 |
| Mailing Telephone | 4173266501 |
| Mailing Fax Number | 4173286338 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2017-01-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
2005029085 | MO | Behavioral Health & Social Service Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1300 N OAKLAND AVE SUITE A |
| City | BOLIVAR |
| State | MO |
| Zip Code | 65613-3018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780647164 | Parkview Surgeons, PC | Surgery | 1300 N Oakland Ave, Bolivar, MO 65613-3018 | 2006-04-07 |
| 1104474741 | Kaylee Jaynelle Ankrom | Nurse Practitioner | 1300 N Oakland Ave, Bolivar, MO 65613-3018 | 2019-08-27 |
| 1316452402 | Rachel Grainger | Social Worker | 1300 N Oakland Ave, Bolivar, MO 65613-3018 | 2017-12-11 |
| 1669891016 | Christina Marie Capps | Internal Medicine | 1300 N Oakland Ave, Bolivar, MO 65613-3018 | 2014-04-14 |
| 1952653487 | Hearing and Audiology Sevices, LLC | Audiologist | 1300 N Oakland Ave, Bolivar, MO 65613-3018 | 2012-10-08 |
| 1578824454 | Gabrielle Guhl | Family Medicine | 1300 N Oakland Ave, Bolivar, MO 65613-3018 | 2012-06-06 |
| 1780869883 | Timothy R Jump | Dentist | 1300 N Oakland Ave, Ste C, Bolivar, MO 65613 | 2008-01-08 |
| 1316145188 | Donald R Jump | Dentist | 1300 N Oakland Ave, Ste C, Bolivar, MO 65613 | 2007-07-03 |
| 1306044177 | Kim S Davison | Dentist | 1300 N Oakland Ave, Ste C, Bolivar, MO 65613 | 2007-07-03 |
| 1831303502 | Citizens Memorial Healthcare | Clinic/Center | 1300 N Oakland Ave, Bolivar, MO 65613-3018 | 2007-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301552 | Casablanca Care Center, LLC | Home Health | 524 S. Albany Avenue, Bolivar, MO 65613 | 2020-09-18 |
| 1669087045 | Revive Medical LLC | Durable Medical Equipment & Medical Supplies | 5000, S Scenic, Bolivar, MO 65613 | 2020-09-11 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1932754744 | Caitlin M Williams | Specialist/Technologist | 1260 S Pike Avenue, Bolivar, MO 65613 | 2019-08-08 |
| 1073022406 | Jacquelyn Rose Kemnic | Dietitian, Registered | Heart Center, 1500 N Oakland Ave, Willard, MO 65613 | 2017-09-28 |
| 1164897161 | Ozarks Resource Group | Clinic/Center | 203 E. Broadway St., Bolivar, MO 65613 | 2015-12-02 |
| 1962895292 | Professional Christian Counseling | Counselor | 4888 S 139th Road, Bolivar, MO 65613 | 2015-03-11 |
| 1073916573 | Scott Leslie Dennis | Physician Assistant | 1500 North Oakland Ave, Citizens Memorial Hospital, Bolivar, MO 65613 | 2014-09-29 |
| 1053712109 | Citizens Memorial Hospital District | Pharmacy | 1301-b North Oakland, Bolivar, MO 65613 | 2014-09-09 |
| 1740680453 | Jamee M Stimpson | Occupational Therapist | 454 S. Main Avenue, Bolivar, MO 65613 | 2014-08-29 |
| Find all providers in zip 65613 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982103784 | Jennifer Michelle White | Physician Assistant | 1501 N Oakland Ave, Bolivar, MO 65613 | 2018-02-07 |
| 1225304587 | Stephanie Marie Aug | Physician Assistant | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2012-03-30 |
| 1396979167 | Oakland Emergency Group LLC | Physician Assistant | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2009-05-08 |
| 1740202142 | Leigh A O'connor | Physician Assistant | 1240 N Butterfield Rd, Bolivar, MO 65613-3016 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922628528 | Sarah Benson | Physician Assistant | 26791 Andrews Ln, Warrenton, MO 63383-6240 | 2020-04-23 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1912538752 | Karen Anghel | Physician Assistant | 804 S Kisner Dr, Independence, MO 64056-3062 | 2020-01-30 |
| 1457822082 | Jwan Alallaf | Physician Assistant | 4121 Roanoke Rd Apt 18, Kansas City, MO 64111-4053 | 2018-12-07 |
| 1730602921 | Saurav N Kayastha | Physician Assistant | 13013 Fuller Ave Ste A, Grandview, MO 64030-2687 | 2017-07-19 |
| 1891227393 | Hollis Smith | Physician Assistant | 2015 Maplewood Commons Dr, Saint Louis, MO 63143-1003 | 2017-04-03 |
| 1992165104 | Cassie Mcgee | Physician Assistant | 1051 Jones St, Kennett, MO 63857-3866 | 2016-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| 1699084814 | Travis James Weiss | Physician Assistant | 6724 State Highway 77, Benton, MO 63736-8238 | 2010-10-05 |
| 1235453150 | James F Patton | Physician Assistant | 913 South St, Stockton, MO 65785-9381 | 2010-03-22 |
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| 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.