Glennette Haney, APRN
Individual provider Active NPI Nurse Practitioner · Alton, MO
NPI 1003967951 · NPPES record last updated Apr 5, 2018
Key facts
- NPI
- 1003967951
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 121404 (MO)
- Practice address
- 100 Medical Drive
Alton, MO 65606-0468 - Phone
- (417) 778-7227
- Fax
- (417) 778-7727
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ozarks Medical Center
Practice addresses (Care Compare)
1100 N Kentucky Ave
West Plains, MO 65775-2029
Phone 41725691116036
Hospital & facility affiliations
- Centerwell Home Health
- Spring River Home Health Agency, Inc
- Ozarks Healthcare
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.96 of 100
- Quality
- 78.58
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 77.82
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230516002268 | MO | Practitioner - Nurse Practitioner | 1153567813 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Current |
Accepting new patients | |
| Ozarks Medical Center | Current |
Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
100 Medical Dr
Alton, MO 65606
Phone (417) 778-7227
300 Warmfork Rd
Thayer, MO 65791
Phone (417) 264-7136
1100 N Kentucky Ave
West Plains, MO 65775
Phone (417) 257-5959
Interoperability endpoints
- g.haney@mhccaremail.com
- glennettehaney@omcmo.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 121404 | MO | Yes |
Addresses
Primary practice location
100 Medical Drive
Alton, MO 65606-0468
Mailing address
PO Box 1100
West Plains, MO 65775-1100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 597843309 | Medicaid | MO | |
| 199440758 | Medicaid | AR |
Other providers in Alton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.