Individual provider Active NPI

Alyssa Marie Emery, MD

  • Family Medicine Physician
  • Sedalia, MO
National Provider Identifier
1134613292
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20210022641 Issued in MO
Practice address
3401 W 10TH St
Sedalia, MO 65301-2112
Phone
(660) 827-2883
Fax
(660) 827-1359
NPI assigned
Jun 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20210022641 MO Primary

Addresses

Primary practice location

3401 W 10TH St
Sedalia, MO 65301-2112

Mailing address

3401 W 10TH St
Sedalia, MO 65301-2112
Phone (660) 827-2883

Other names 1

  • Alyssa Marie Cole Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210811003475 MO Practitioner - Family Practice 1355697715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bothwell Regional Health CenterGroup PAC ID 6103714126, 109 clinicians

Practice addresses (Care Compare)

3401 W 10TH St
Bothwell OB GYN Clinic
Sedalia, MO 65301-2112
Phone (660) 827-2883

Hospital & facility affiliations

  • Phoenix Home Care Home health agency, Jefferson City, MO, CCN 267597
  • Johnson County Community Health Services Home health agency, Warrensburg, MO, CCN 267058
  • Bothwell Regional Health Center Hospital, Sedalia, MO, CCN 260009

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20210022641MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bothwell Regional Health Center Current Accepting new patients
Bothwell Regional Health Center CurrentSince Aug 9, 2021 Accepting new patients
Bothwell Regional Health Center Family Medicine CurrentSince Aug 9, 2021 Accepting new patients

Locations

3700 W 10th St
Ste 100
Sedalia, MO 65301
Phone (660) 827-0015

601 E 14th St
Sedalia, MO 65301
Phone (660) 826-8833

3401 W 10th St
Sedalia, MO 65301
Phone (660) 827-0015

1765 Commercial St
Warsaw, MO 65355
Phone (660) 438-6800

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1134613292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W 10TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012112",
            "telephone_number": "660-827-2883",
            "fax_number": "660-827-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W 10TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012112",
            "telephone_number": "660-827-2883",
            "fax_number": "660-827-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERY",
        "first_name": "ALYSSA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "20210022641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "COLE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sedalia, MO

Sources for this page

Verify at the official NPI Registry.