NPIMap

Individual provider Active NPI

Deirdre Stocks

  • Family Nurse Practitioner
  • Shell Knob, MO
National Provider Identifier
1043874803
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2019010873 Issued in MO
Practice address
25376 State Highway 39 Ste 301
Shell Knob, MO 65747-7900
Phone
(417) 269-2470
Fax
(417) 269-2473
NPI assigned
Apr 26, 2019
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2019010873 MO Primary

Addresses

Primary practice location

25376 State Highway 39 Ste 301
Shell Knob, MO 65747-7900

Mailing address

PO Box 802843
Kansas City, MO 64180-2843
Phone (417) 730-6430

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
I20240523001294 MO Practitioner - Nurse Practitioner 3274929021 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

448 State Hwy 248
Suite 120
Branson, MO 65616-3725
Phone (417) 337-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince May 6, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince May 6, 2024 Accepting new patients
Mercy Clinic Springfield Communities Family CurrentSince May 6, 2024 Accepting new patients

Locations

448 State Highway 248
Ste 120
Branson, MO 65616
Phone (417) 337-5000

448 State Highway 248
Ste 140
Branson, MO 65616
Phone (417) 337-9808

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

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 10

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": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1043874803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802843",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641802843",
            "telephone_number": "417-730-6430",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25376 STATE HIGHWAY 39 STE 301",
            "city": "SHELL KNOB",
            "state": "MO",
            "postal_code": "657477900",
            "telephone_number": "417-269-2470",
            "fax_number": "417-269-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKS",
        "first_name": "DEIRDRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-26",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019010873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shell Knob, MO

Sources for this page

Verify at the official NPI Registry.