NPIMap

Individual provider Active NPI

Carla K. Athen, FNP-C

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1134501695
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2015019756 Issued in MO
Practice address
3231 S National Ave
Suite 300
Springfield, MO 65807-7304
Phone
(417) 841-0285
Fax
(417) 841-0286
NPI assigned
Jun 22, 2015
Last updated
Oct 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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 2015019756 MO Primary

Addresses

Primary practice location

3231 S National Ave
Suite 300
Springfield, MO 65807-7304

Mailing address

PO Box 505164
Saint Louis, MO 63150-5164
Phone (417) 829-4620

Other identifiers 1

IdentifierTypeStateIssuer
1134501695MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150812007525 MO Practitioner - Nurse Practitioner 6002121670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

3231 S National Ave
Springfield, MO 65807-7304
Phone (417) 888-5658

448 State Hwy 248
Suite 150
Branson, MO 65616-3725
Phone (417) 336-6713

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015019756MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Apr 30, 2020 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jul 5, 2015 Accepting new patients
Mercy Clinic Springfield Communities Family CurrentSince Jul 5, 2015 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

448 State Highway 248
Ste 150
Branson, MO 65616
Phone (417) 336-6713

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

3231 S National Ave
Ste 220
Springfield, MO 65807
Phone (417) 820-7450

3231 S National Ave
Ste 300
Springfield, MO 65807
Phone (417) 888-5658

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

Interoperability endpoints

  • Direct secure messaging: cathen11010@directc.mercy.net

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 9

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": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1134501695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505164",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505164",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 S NATIONAL AVE",
            "address_2": "SUITE 300",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077304",
            "telephone_number": "417-841-0285",
            "fax_number": "417-841-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATHEN",
        "first_name": "CARLA",
        "middle_name": "K.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015019756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134501695",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.