JUSTIN KYLE BOUDREAUX
NPI 1255847463
Counselor - Professional in Joplin, MO

Active since December 26, 2017PECOS Enrolled
530 E 34TH ST, JOPLIN, MO 64804(417) 347-7600 Get Directions Write a Review

NPPES record last updated: December 26, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Justin Kyle Boudreaux NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUSTIN KYLE BOUDREAUX (NPI 1255847463) is an individual professional provider in Joplin, Missouri, licensed in Missouri (2017036049) and active in the NPI registry since December 2017. He is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1255847463
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameJUSTIN KYLE BOUDREAUX
Location Address530 E 34TH STJoplin, MO 64804-3926
Mailing AddressPo Box 2526Joplin, MO 64803-2526 · (417) 347-7600
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateDecember 26, 2017
✔ NPI 1255847463 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MO · 2017036049
530 E 34TH ST, Joplin, MO 64804

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justin Kyle Boudreaux is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7214491570
PECOS Enrollment IDI20260708003950
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Justin Boudreaux reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Federally Qualified Health Center (FQHC)
1809 S CONNOR AVE
Joplin, MO 64804
  • Reassigned Medicare billing, Missouri enrollment
  • 66 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Clinical)
530 E 34TH ST
JOPLIN, MO 64804
Marriage & Family Therapist
530 E 34TH ST
JOPLIN, MO 64804
Psychiatry & Neurology (Child & Adolescent Psychiatry)
530 E 34TH ST, SUITE 201
JOPLIN, MO 64804
Nurse Practitioner (Psychiatric/Mental Health)
530 E 34TH ST
JOPLIN, MO 64804
Nurse Practitioner (Family)
530 E 34TH ST, 202
JOPLIN, MO 64804
Counselor (Professional)
530 E 34TH ST
JOPLIN, MO 64804
Social Worker (Clinical)
530 E 34TH ST
JOPLIN, MO 64804
Social Worker (Clinical)
530 E 34TH ST
JOPLIN, MO 64804

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Boudreaux's NPI number?

The NPI number for Justin Boudreaux is 1255847463. It was assigned to this individual provider in the NPPES registry on December 26, 2017.

Where is Justin Boudreaux located?

Justin Boudreaux practices at 530 E 34th St, Joplin, MO 64804. The listed phone number is (417) 347-7600.

What is Justin Boudreaux's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Justin Boudreaux enrolled in Medicare?

Yes. Justin Boudreaux is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Justin Boudreaux's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Justin Boudreaux reassigns Medicare benefits to Ozark Tri-County Health Care Consortium (Joplin, MO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Justin Boudreaux's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Justin Boudreaux accept?

Health plans from Anthem Blue Cross and Blue Shield and Cox HealthPlans list Justin Boudreaux as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Justin Boudreaux was last updated on December 26, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.