KATEY ANN STAFFORD (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1104483742
Psychiatric/Mental Health Nurse Practitioner
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for KATEY ANN STAFFORD (PMHNP)
Burrell Behavioral Health, 1300, East Bradford Parkway, Springfield, Greene County, Missouri, 65804, United States
SPRINGFIELD, MO 658044264
Phone: (417) 761-5000
Fax: (417) 761-5011
Type: Mailing
2750 E Beltline Ave NE Fl 3
Grand Rapids, MI 495258614
Phone: (616) 447-5820
Type: Location
2750 E BELTLINE AVE NE FL 3
GRAND RAPIDS, MI 495258614
Phone: (616) 447-5820
Type: Location
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 495032560
Phone:
Type: Mailing
411 3RD ST
MONETT, MO 657082008
Phone: (417) 476-1000
Fax: (417) 943-5693
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $169.
Total Amount is formed as General ($169) + Research ($0) + Ownership ($0) = $169.
Last reported payment date: 2024-09-11 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($29).
Total Amount
$169
General + Research + Ownership
Payments
9
Total payment records
General Amount
$169
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-11
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.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-07-24
PECOS data refreshed: 2026-05-27
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 |
|---|---|---|---|---|
| I20190724002806 | 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 65804)
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