Individual provider Active NPI

Harwinder K Dhanoa

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1003594318
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023025365 Issued in MO
Practice address
1540 E Evergreen St
Springfield, MO 65803-4300
Phone
(417) 823-2900
NPI assigned
Jul 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2023025365 MO
Family Nurse Practitioner 363LF0000X 2023025365 MO Primary

Addresses

Primary practice location

1540 E Evergreen St
Springfield, MO 65803-4300

Mailing address

3606 N Thistlewood CT
Springfield, MO 65803-6401
Phone (417) 987-8658

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
I20230721003168 MO Practitioner - Nurse Practitioner 4587024567 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

363 E Old Route 66
MC Family Medicine Strafford
Strafford, MO 65757-7801
Phone (417) 736-9175

363 E Route 66
MC Family Medicine Strafford
Strafford, MO 65757-7801
Phone (417) 736-9175

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sgoh Acquisition Inc CurrentSince Jul 17, 2023 Accepting new patients
Sgoh Acquisition Inc CurrentSince Jul 17, 2023 Accepting new patients
Primrose Nephrology, Inc. Current Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince May 6, 2024 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince May 6, 2024 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince May 6, 2024 Accepting new patients

Locations

1101 Jackson St SW
Gravette, AR 72736
Phone (479) 787-5221

106 S Hickory St
Mount Vernon, MO 65712
Phone (417) 466-4110

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1540 E Evergreen St
Springfield, MO 65803
Phone (417) 823-2900

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

363 E Old Route 66
Strafford, MO 65757
Phone (417) 736-9175

Organizations & group practices 6

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 11

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": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1003594318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3606 N THISTLEWOOD CT",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658036401",
            "telephone_number": "417-987-8658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 E EVERGREEN ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658034300",
            "telephone_number": "417-823-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHANOA",
        "first_name": "HARWINDER",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2023025365",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023025365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.