Individual provider Active NPI

Lacosta Kay Gaines, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Shelbina, MO
National Provider Identifier
1003287848
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2015035184 Issued in MO
Practice address
400 S Center St
Shelbina, MO 63468-1404
Phone
(573) 588-4131
Fax
(573) 588-4876
NPI assigned
Oct 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 2015035184 MO
Family Nurse Practitioner 363LF0000X 2015035184 MO Primary

Addresses

Primary practice location

400 S Center St
Shelbina, MO 63468-1404

Mailing address

400 S Center St
Shelbina, MO 63468-1404
Phone (573) 588-4131

Other practice location 1

6500 Hospital Dr
Hannibal, MO 63401-6890
Phone (573) 629-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151124001344 MO Practitioner - Nurse Practitioner 5496055428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Columbia School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

211 S 3Rd St
Louisiana, MO 63353-2000
Phone (573) 754-5555

400 S Ctr St
Shelbina, MO 63468-1404
Phone (573) 588-4131

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hannibal Regional Healthcare System, Inc CurrentSince Jun 22, 2020 Accepting new patients
Hannibal Regional Healthcare System Inc CurrentSince Jun 22, 2020 Accepting new patients

Locations

1802 Elm St
Canton, MO 63435
Phone (573) 288-5360

6500 Hospital Dr
Hannibal, MO 63401
Phone (573) 629-3400

400 S Center St
Shelbina, MO 63468
Phone (573) 588-4131

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
  • FHIR API: https://api.platform.athenahealth.com/2245/brand/2/csg/81/fhir/r4
  • Direct secure messaging: lacostagaines@hrmg.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1003287848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S CENTER ST",
            "city": "SHELBINA",
            "state": "MO",
            "postal_code": "634681404",
            "telephone_number": "573-588-4131",
            "fax_number": "573-588-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S CENTER ST",
            "city": "SHELBINA",
            "state": "MO",
            "postal_code": "634681404",
            "telephone_number": "573-588-4131",
            "fax_number": "573-588-4876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6500 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Hannibal",
            "state": "MO",
            "postal_code": "634016890",
            "country_code": "US",
            "telephone_number": "573-629-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAINES",
        "first_name": "LACOSTA",
        "middle_name": "KAY",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-19",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2015035184",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015035184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbina, MO

Sources for this page

Verify at the official NPI Registry.