Unknown Individual – Psychiatric/Mental Health Nurse Practitioner, NPI 1013480979
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
Provider Addresses for Unknown Individual
811 S Business Highway 13 Ste A
Lexington, MO 640671572
Phone: (877) 344-3572
Fax: (866) 228-4492
Type: Location
608 Missouri St
Waverly, MO 640968241
Phone: (877) 344-3572
Fax: (866) 228-4492
Type: Location
718 Harvest Hills Dr
Carrollton, MO 646332412
Phone: (877) 344-3572
Fax: (866) 228-4492
Type: Location
324 S Hudson St
Buckner, MO 640168142
Phone: (877) 344-3572
Fax: (866) 228-4492
Type: Location
206 N Bismark St Ste A
Concordia, MO 640208101
Phone: (877) 344-3572
Fax: (866) 228-4492
Type: Location
2305 S HIGHWAY 65 BLDG A
MARSHALL, MO 653403702
Phone: (660) 886-7800
Fax: (660) 831-3306
Type: Location
65, Marshall Drive, Stapleford, Bramcote, Nottingham, Nottinghamshire, East Midlands, England, NG9 3LE, United Kingdom
MARSHALL, MO 653403702
Phone: (660) 831-3759
Fax: (660) 831-3326
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 41 Open Payments records for all available years, with a total value of $697.
Total Amount is formed as General ($697) + Research ($0) + Ownership ($0) = $697.
Last reported payment date: 2024-11-06 • Largest payer in this snapshot: ABBVIE INC. ($527).
Total Amount
$697
General + Research + Ownership
Payments
41
Total payment records
General Amount
$697
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-06
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190122000728 | I | Nurse Practitioner | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 64067)
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