Individual provider Active NPI

Marcy A Emmons, PA-C

  • Physician Assistant
  • Jackson, MO
National Provider Identifier
1073515714
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2022040627 Issued in MO
Practice address
2130 E Jackson Blvd
Jackson, MO 63755-2907
Phone
(573) 243-8408
Fax
(573) 243-0445
NPI assigned
Aug 12, 2005
Last updated
Oct 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-002359 IL
Physician Assistant 363A00000X 2022040627 MO Primary

Addresses

Primary practice location

2130 E Jackson Blvd
Jackson, MO 63755-2907

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

Other names 1

  • Marcy A Schulte Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050107000347 IL Practitioner - Physician Assistant 9133177066 Reassigns benefits to 2 organizations
I20221115000230 MO Practitioner - Physician Assistant 9133177066 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

150 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049

211 Saint Francis Dr
Cape Girardeau, MO 63703-8399

2130 E Jackson Blvd
Jackson, MO 63755-2907
Phone (573) 243-3115

24 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as group
Quality
65.2
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-002359ILMDPhysician Assistant
2022040627MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center CurrentSince Sep 7, 2023 Accepting new patients
Community Health & Emergency Services, Inc. CurrentSince Feb 15, 2010 Accepting new patients
Cape Laboratory & Pathology, LC Current Accepting new patients
Saint Francis Medical Center CurrentSince Sep 7, 2023 Accepting new patients
Deaconess Union County Hospital, Inc Past Accepting new patients
Saint Francis Medical Center Past Accepting new patients

Locations

1702 N Kingshighway St
Cpe Girardeau, MO 63701
Phone (573) 339-0483

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

2130 E Jackson Blvd
Jackson, MO 63755
Phone (573) 243-3115

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

Interoperability endpoints

  • Direct secure messaging: memmons104926@surescripts.sfmc.net

Organizations & group practices 9

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 3

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1073515714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 E JACKSON BLVD",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637552907",
            "telephone_number": "573-243-8408",
            "fax_number": "573-243-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMONS",
        "first_name": "MARCY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-002359",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2022040627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCY",
            "last_name": "SCHULTE",
            "middle_name": "A",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MO

Sources for this page

Verify at the official NPI Registry.