Individual provider Active NPI

Joni Ahern, NP

  • Adult Health Nurse Practitioner
  • Columbia, MO
National Provider Identifier
1033570205
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2016007900 Issued in 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
Last updated
Mar 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2016007900 MO Primary
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

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
I20160517001744 MO Practitioner - Nurse Practitioner 9133418072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renova Medical Center LLCGroup PAC ID 3577811736, 4 clinicians

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016007900MOMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renova Medical Center, LLC CurrentSince Jun 28, 2018 Accepting new patients
Rose Family Chiropractic LLC Past Accepting new patients

Locations

1401 Forum Blvd
Ste 101
Columbia, MO 65203
Phone (573) 234-1367

1401 Forum Blvd
Ste 202
Columbia, MO 65203
Phone (573) 228-0217

503 E Nifong Blvd
Ste 102
Columbia, MO 65201

Organizations & group practices 2

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": "1458000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1033570205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 PORTLAND ST",
            "address_2": "STE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016677",
            "telephone_number": "573-777-8818",
            "fax_number": "573-777-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 PORTLAND ST",
            "address_2": "STE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016677",
            "telephone_number": "573-777-8818",
            "fax_number": "573-777-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHERN",
        "first_name": "JONI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-15",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2016007900",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2016007900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.