Individual provider Active NPI

Amy E Torres, AGACNP-BC

  • Nurse Practitioner
  • Sullivan, MO
National Provider Identifier
1013440064
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2017007849 Issued in MO
Practice address
965 Mattox Dr
Sullivan, MO 63080-2365
Phone
(573) 860-6000
NPI assigned
Apr 6, 2017
Last updated
Aug 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2017007849 MO Primary
Acute Care Nurse Practitioner 363LA2100X 2017007849 MO

Addresses

Primary practice location

965 Mattox Dr
Sullivan, MO 63080-2365

Mailing address

965 Mattox Dr
Sullivan, MO 63080-2365
Phone (573) 860-6000

Other practice location 1

1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-8899

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20170504000215 MO Practitioner - Nurse Practitioner 9234416025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Saint Louis University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missouri Baptist Hospital of SullivanGroup PAC ID 2668380148, shared by 8 NPIs, 40 clinicians

Practice addresses (Care Compare)

721 Sappington Bridge Rd
Sullivan, MO 63080-2354

751 Sappington Bridge Rd
Sullivan, MO 63080-2354
Phone (573) 468-4186

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017007849MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri Baptist Hospital of Sullivan CurrentSince Sep 1, 2022 Accepting new patients
Missouri Baptist Hospital of Sullivan Current Accepting new patients
Missouri Baptist Hospital of Sullivan CurrentSince Sep 1, 2022 Accepting new patients
Missouri Baptist Hospital of Sullivan CurrentSince Sep 1, 2022 Accepting new patients
Missouri Baptist Hospital of Sullivan Nurse Practitioner Past Accepting new patients

Locations

102 Ozark Dr
#B
Cuba, MO 65453
Phone (573) 860-6600

965 Mattox Dr
Sullivan, MO 63080
Phone (573) 468-7054

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1013440064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 MATTOX DR",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802365",
            "telephone_number": "573-860-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 MATTOX DR",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802365",
            "telephone_number": "573-860-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654012905",
            "country_code": "US",
            "telephone_number": "573-458-8899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TORRES",
        "first_name": "AMY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-06",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2017007849",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2017007849",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "965 Mattox Dr",
            "city": "Sullivan",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630802365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sullivan, MO

Sources for this page

Verify at the official NPI Registry.