Individual provider Active NPI

Mary Elizabeth Jarrells, FNP-BC

  • Family Nurse Practitioner
  • Cape Girardeau, MO
National Provider Identifier
1093085458
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2011039076 Issued in MO
Practice address
304 S Mount Auburn Rd
Cape Girardeau, MO 63703-4920
Phone
(573) 651-1687
Fax
(573) 651-8734
NPI assigned
Jan 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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 2011039076 MO Primary

Addresses

Primary practice location

304 S Mount Auburn Rd
Cape Girardeau, MO 63703-4920

Mailing address

304 S Mount Auburn Rd
Cape Girardeau, MO 63703-4920
Phone (573) 651-1687

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
I20120202000606 MO Practitioner - Nurse Practitioner 3274790282 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Big Springs Medical Association CurrentSince Dec 2, 2019 Accepting new patients
Big Springs Medical Association Current Accepting new patients
Big Springs Medical Association Past Accepting new patients
Midwest Health Group Convenient Care, LLC Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Physician Groups LC Past Accepting new patients

Locations

202 Allen St
Annapolis, MO 63620
Phone (573) 598-4213

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1093085458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 S MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034920",
            "telephone_number": "573-651-1687",
            "fax_number": "573-651-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 S MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034920",
            "telephone_number": "573-651-1687",
            "fax_number": "573-651-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRELLS",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-03",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2011039076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.