Unknown Individual – Family Nurse Practitioner, NPI 1114195187
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1201, North Rutherford Street, Macon, Macon County, Missouri, 63552, United States
MACON, MO 635522020
Phone: (660) 385-8901
Fax: (660) 385-8708
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $124.
Total Amount is formed as General ($124) + Research ($0) + Ownership ($0) = $124.
Last reported payment date: 2024-03-12 • Largest payer in this snapshot: Dexcom, Inc. ($46).
Total Amount
$124
General + Research + Ownership
Payments
6
Total payment records
General Amount
$124
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dexcom, Inc. | $46 |
| Bausch & Lomb Americas Inc. | $35 |
| Abbott Laboratories | $23 |
| ABBVIE INC. | $20 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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 63552)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | MO | |
| Diagnostic Radiology | MO | |
| Internal Medicine, Emergency Medicine | MO | |
| - | MO | |
| Family Practice | MO | |
| Family Practice | MO | |
| Family Practice | MO | |
| Family Practice | MO | |
| Family Practice | MO | |
| Family Practice | MO |
Reviews
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