Mark Alan Proffer, ACNPC-AG

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2023041355 Issued in MO

Practice address

24 S Mount Auburn Rd
Cape Girardeau, MO 63703-4914

Phone

(573) 331-5544

NPI assigned

Jul 11, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint Francis Medical Center 441 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Cape Girardeau, MO, CCN 260183

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mproffer16493@surescripts.sfmc.net

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

• Saint Francis Medical Center

  • Anesthesiology Physician
  • Cape Girardeau, MO
  • NPI 1356304489

  MO

  Medicare reassignment Care Compare group NPD
• Saint Francis Medical Center

  • Rural Health Clinic/Center
  • Farmington, MO
  • NPI 1013585561
  Care Compare group
• Saint Francis Medical Center

  • Rural Health Clinic/Center
  • Scott City, MO
  • NPI 1033686886
  Care Compare group
• Saint Francis Medical Center

  • Community Based Hospice Care Agency
  • Cape Girardeau, MO
  • NPI 1053723478
  Care Compare group
• Saint Francis Medical Center

  • Community/Retail Pharmacy
  • Cape Girardeau, MO
  • NPI 1104911965
  Care Compare group
• Saint Francis Medical Center

  • Clinical Medical Laboratory
  • Dexter, MO
  • NPI 1235916990
  Care Compare group
• Saint Francis Medical Center

  • Rural Health Clinic/Center
  • Dexter, MO
  • NPI 1366831943
  Care Compare group
• Saint Francis Medical Center

  • Specialty Pharmacy
  • Cape Girardeau, MO
  • NPI 1376397539
  Care Compare group
• Saint Francis Medical Center

  • Rural Health Clinic/Center
  • Charleston, MO
  • NPI 1417424151
  Care Compare group
• Saint Francis Medical Center

  • Rural Health Clinic/Center
  • Piedmont, MO
  • NPI 1457757767
  Care Compare group
• Saint Francis Medical Center

  • General Acute Care Hospital
  • Cape Girardeau, MO
  • NPI 1467412726
  Care Compare group
• Saint Francis Medical Center

  • Rural Health Clinic/Center
  • Cape Girardeau, MO
  • NPI 1518372481
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Francis Medical Center

  • General Acute Care Hospital
  • Cape Girardeau, MO
  • NPI 1467412726

  Hospital

  Care Compare affiliation
• Saint Francis Medical Center

  • Internal Medicine Physician
  • Cape Girardeau, MO
  • NPI 1578513016

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1063259646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 COUNTY ROAD 435",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637558184",
            "telephone_number": "573-803-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 S MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034914",
            "telephone_number": "573-331-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFFER",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2023041355",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2023041355",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2023041355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Cape Girardeau, MO
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.