Jordan Brotz, FNP
Individual provider Active NPI Family Nurse Practitioner · Hayti, MO
NPI 1104574334 · NPPES record last updated Mar 16, 2022
Key facts
- NPI
- 1104574334
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2022008047 (MO)
- Practice address
- 946 E Reed St
Hayti, MO 63851-1243 - Phone
- (573) 359-1372
- NPI assigned
- Mar 16, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- McPherson Medical and Diagnostic LLC
Practice addresses (Care Compare)
216 W Main St
Steele, MO 63877-1436
Phone (573) 695-2181
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220330000987 | MO | Practitioner - Nurse Practitioner | 8325434491 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McPherson Medical & Diagnostic, LLC | Current |
Accepting new patients | |
| McPherson Medical & Diagnostic, LLC | Current | Accepting new patients | |
| McPherson Medical & Diagnostic, LLC | Current |
Accepting new patients |
Locations
223 S 3rd St
Hayti, MO 63851
Phone (573) 359-2019
907 E Reed St
Hayti, MO 63851
Phone (573) 359-3230
304 Teaco Rd
Ste A
Kennett, MO 63857
Phone (573) 559-3591
216 W Main St
Ste B
Steele, MO 63877
Phone (573) 695-2181
216 W Main St
Ste A
Steele, MO 63877
Phone (573) 695-2181
216 W Main St
Steele, MO 63877
Phone (573) 695-2181
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2022008047 | MO | Yes |
Addresses
Primary practice location
946 E Reed St
Hayti, MO 63851-1243
Mailing address
946 E Reed St
Hayti, MO 63851-1243
Phone (573) 359-1372
Other providers in Hayti, MO
- Cynthia Branham
- Taranda Latrist Brewster
- Alexander Payton Bridges
- Evelyn Broadhurst
- Rebecca Brooks
- Heather Brown
- Jennifer Brown
- Keshaun Brown
- Maiven Mykayle Brown
- Dustin Allen Burdine
All providers in Hayti, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.