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Individual provider Active NPI

Beth M Schrage, RNCSFNP

  • Community Health Nurse Practitioner
  • Edina, MO
National Provider Identifier
1023094240
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Nurse PractitionerTaxonomy code 363LC1500X
License
107529 Issued in MO
Practice address
100 E Jackson St
Edina, MO 63537-1335
Phone
(660) 397-3571
Fax
(660) 397-2307
NPI assigned
Dec 20, 2005
Last updated
Apr 27, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Nurse Practitioner 363LC1500X 107529 MO Primary
Family Nurse Practitioner 363LF0000X 107529 MO

Addresses

Primary practice location

100 E Jackson St
Edina, MO 63537-1335

Mailing address

1416 Crown Drive
Kirksville, MO 63501-2548
Phone (660) 627-5757

Other identifiers 1

IdentifierTypeStateIssuer
426885000MedicaidMO

Other names 1

  • Beth M Mackey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050328000187 MO Practitioner - Nurse Practitioner 8224084819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

104 E Jackson St
Edina, MO 63537-1335
Phone (660) 397-3517

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
107529MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Missouri Health Council Inc CurrentSince Jan 1, 2002 Accepting new patients
Northeast Missouri Health Council, Inc. CurrentSince Jan 1, 2002 Accepting new patients
Northeast Missouri Health Council, Inc. Family Past Accepting new patients

Locations

104 E Jackson St
Edina, MO 63537
Phone (660) 397-3517

1416 Crown Dr
Kirksville, MO 63501
Phone (660) 627-4493

1506 Crown Dr
Kirksville, MO 63501
Phone (660) 627-4493

800 W Jefferson St
Kirksville, MO 63501
Phone (660) 626-2235

Interoperability endpoints

  • Direct secure messaging: beth.schrage.p1@direct.nmhcinc.nextgenshare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1023094240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 CROWN DRIVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635012548",
            "telephone_number": "660-627-5757",
            "fax_number": "660-627-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E JACKSON ST",
            "city": "EDINA",
            "state": "MO",
            "postal_code": "635371335",
            "telephone_number": "660-397-3571",
            "fax_number": "660-397-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRAGE",
        "first_name": "BETH",
        "middle_name": "M",
        "credential": "RNCSFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-20",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "MO",
            "license": "107529",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "107529",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "426885000",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "MACKEY",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edina, MO

Sources for this page

Verify at the official NPI Registry.