Individual provider Active NPI

Connie Lynne Gurley, APRN-BC, FNP

  • Family Nurse Practitioner
  • Kennett, MO
National Provider Identifier
1104115153
Registry record updated Mar 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2011011192 Issued in MO
Practice address
1231 1St St
Suite 5
Kennett, MO 63857-2527
Phone
(573) 888-8690
Fax
(573) 717-1085
NPI assigned
Mar 30, 2011
Last updated
Mar 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2013

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 2011011192 MO Primary

Addresses

Primary practice location

1231 1St St
Suite 5
Kennett, MO 63857-2527

Mailing address

PO Box 728
Kennett, MO 63857-0728
Phone (573) 888-8690

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
I20130308000301 MO Practitioner - Nurse Practitioner 8820243249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

216 W Main St
Steele, MO 63877-1436
Phone (573) 695-2181

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McPherson Medical & Diagnostic, LLC Current Accepting new patients
McPherson Medical & Diagnostic, LLC CurrentSince Jan 1, 2016 Accepting new patients
McPherson Medical & Diagnostic, LLC CurrentSince Jan 1, 2016 Accepting new patients
McPherson Medical & Diagnostic, LLC Past Accepting new patients

Locations

223 S 3rd St
Hayti, MO 63851
Phone (573) 359-2019

304 Teaco Rd
Ste A
Kennett, MO 63857
Phone (573) 559-3591

901 W Commercial St
Kennett, MO 63857
Phone (573) 695-2181

216 W Main St
Steele, MO 63877
Phone (573) 695-2181

216 W Main St
Ste B
Steele, MO 63877
Phone (573) 695-2181

Interoperability endpoints

  • Direct secure messaging: cgurley@mmadl-mo.direct.office.nextgen.com

Organizations & group practices 4

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 1

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": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1104115153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 728",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638570728",
            "telephone_number": "573-888-8690",
            "fax_number": "573-717-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 1ST ST",
            "address_2": "SUITE 5",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638572527",
            "telephone_number": "573-888-8690",
            "fax_number": "573-717-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURLEY",
        "first_name": "CONNIE",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "APRN-BC, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-30",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2011011192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett, MO

Sources for this page

Verify at the official NPI Registry.