Individual provider Active NPI

Jennifer Marie Storey, FNP-BC

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1073332862
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2019043805 Issued in MO
Practice address
3322 S Campbell Ave Ste T-1
Springfield, MO 65807-4980
Phone
(417) 220-4480
Fax
(417) 414-0017
NPI assigned
Oct 8, 2024
Last updated
Jun 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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 2019043805 MO Primary

Addresses

Primary practice location

3322 S Campbell Ave Ste T-1
Springfield, MO 65807-4980

Mailing address

209 Bald Cypress CT
Hollister, MO 65672-6349
Phone (417) 239-4280

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
I20241120000157 MO Practitioner - Nurse Practitioner 0042745671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elite Professional Providers, LLCGroup PAC ID 1254792740, 7 clinicians

Practice addresses (Care Compare)

3322 S Campbell Ave
Suite T 1
Springfield, MO 65807-4980
Phone (417) 220-4480

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019043805MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Professional Providers, LLC Family CurrentSince Oct 1, 2024 Accepting new patients

Locations

2135 E Independence St
Springfield, MO 65804
Phone (305) 482-1494

3322 S Campbell Ave
Ste T1
Springfield, MO 65807
Phone (417) 220-4480

Organizations & group practices 1

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 5

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": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1073332862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 BALD CYPRESS CT",
            "city": "HOLLISTER",
            "state": "MO",
            "postal_code": "656726349",
            "telephone_number": "417-239-4280",
            "fax_number": "417-414-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 S CAMPBELL AVE STE T-1",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658074980",
            "telephone_number": "417-220-4480",
            "fax_number": "417-414-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOREY",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-08",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019043805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.