Joni Ahern, NP
Individual provider Active NPI Adult Health Nurse Practitioner · Columbia, MO
NPI 1033570205 · NPPES record last updated Mar 17, 2016
Key facts
- NPI
- 1033570205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 2016007900 (MO)
- Practice address
- 210 Portland St
Ste 100
Columbia, MO 65201-6677 - Phone
- (573) 777-8818
- Fax
- (573) 777-8819
- NPI assigned
- Mar 15, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Renova Medical Center LLC
Practice addresses (Care Compare)
1401 Forum Blvd
Suite 202
Columbia, MO 65203-1915
Phone (573) 234-1367
211 NW Executive Way
Suite E
Lees Summit, MO 64063-1846
Phone (573) 234-1367
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 |
|---|---|---|---|---|
| I20160517001744 | MO | Practitioner - Nurse Practitioner | 9133418072 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016007900 | MO | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renova Medical Center, LLC | Current |
Accepting new patients | |
| Rose Family Chiropractic LLC | Past | Accepting new patients |
Locations
1401 Forum Blvd
Ste 101
Columbia, MO 65203
Phone (573) 228-0217
1401 Forum Blvd
Ste 202
Columbia, MO 65203
Phone (573) 234-1367
503 E Nifong Blvd
Ste 102
Columbia, MO 65201
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 2016007900 | MO | Yes |
| Gerontology Nurse Practitioner | 363LG0600X | 2016007900 | MO |
Addresses
Primary practice location
210 Portland St
Ste 100
Columbia, MO 65201-6677
Mailing address
210 Portland St
Ste 100
Columbia, MO 65201-6677
Phone (573) 777-8818
Other providers in Columbia, MO
- Ankita Aggarwal
- Archna Aggarwal
- Arpit Aggarwal
- Reza Aghaei
- Aman Aher
- Pauline Hannah Aherrera
- Arfa Ahmad
- Haseeb Ahmad
- Lindsay Tierra Ahmad
- Salman Ahmad
All providers in Columbia, MO · Adult Health Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2016. 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.