Sara Revelle, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

096829 Issued in MO

Practice address

900 W Nifong Ste 101
Columbia, MO 65203-3032

Phone

(573) 499-9009

Fax

(573) 499-4400

NPI assigned

Oct 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boone Hospital Center Hospital, Columbia, MO, CCN 260068

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sararevelle@mhccaremail.com

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.

• Boone Physician Services, LLC

  • Multi-Specialty Clinic/Center
  • Columbia, MO
  • NPI 1760893259
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CH Allied Services, Inc

  dba Boone Hospital Center

  • Cardiac Rehabilitation Clinic/Center
  • Columbia, MO
  • NPI 1548734734

  Hospital

  Care Compare affiliation
• CH Allied Services, Inc.

  dba Boone Hospital Center

  • General Acute Care Hospital
  • Columbia, MO
  • NPI 1902817844
  Care Compare affiliation

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1124104831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR",
            "address_2": "STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "573-499-9009",
            "fax_number": "573-499-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W NIFONG STE 101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652033032",
            "telephone_number": "573-499-9009",
            "fax_number": "573-499-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVELLE",
        "first_name": "SARA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "096829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "096829",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Restore Balance Integrative Wellness
• Retina Associates of Mid Missouri, LLC
• Retina Associates of Missouri, P.C.
• Beth R Reule, RD, CSP, LD
• Carin E Reust, MD
• Revive Rehab, LLC (Revive Rehab Physical Therapy)
• Allyson Reynolds
• Molly Kate Reynolds, PA-C
• Katarina Ribar, MA, PLPC
• Holly Elizabeth Rice, PLPC

• Family Nurse Practitioner in Columbia, MO
• Providers in Columbia, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.