Active NPI
Jessica Nichole Mickels, RNFA
- Adult Health Nurse Practitioner
- Hannibal, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 2023040437
- Practice address
- 6000 Hospital Dr
Hannibal, MO 63401-6887 - Phone
- (573) 248-5115
- Fax
- (573) 248-5196
- NPI assigned
- Nov 4, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 2023040437 | MO | |
| Registered Nurse First Assistant | 163WR0006X | 2013025149 | MO | |
| Gerontology Nurse Practitioner | 363LG0600X | 2023040437 | MO | |
| Adult Health Nurse Practitioner | 363LA2200X | 2023040437 | MO | Primary |
Addresses
Primary practice location
6000 Hospital Dr
Hannibal, MO 63401-6887
Mailing address
PO Box 551
Hannibal, MO 63401-0551
Phone (573) 248-5115
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6500 Hospital Dr
Hannibal, MO 63401-6890
Phone (573) 248-1300
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013025149 | MO | MD | Registered Nurse First Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hannibal Regional Healthcare System, Inc | Current | Accepting new patients | |
| Hannibal Regional Healthcare System Inc | Current | Accepting new patients | |
| Hannibal Regional Healthcare System, Inc | Past | Accepting new patients |
Locations
6000 Hospital Dr
Hannibal, MO 63401
Phone (573) 248-5460
6500 Hospital Dr
Hannibal, MO 63401
Phone (573) 629-3400
Interoperability endpoints
- https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
- jessicamickels@hrmg.allscriptsdirect.net
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.
-
- Multi-Specialty Clinic/Center
- Hannibal, MO
- NPI 1134311392
-
- Multi-Specialty Clinic/Center
- Hannibal, MO
- NPI 1003956095
-
- Multi-Specialty Clinic/Center
- Kirksville, MO
- NPI 1447789300
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rural Acute Care Hospital
- Hannibal, MO
- NPI 1922042704
-
- General Acute Care Hospital
- Quincy, IL
- NPI 1760571699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699228800000",
"number": "1164066023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 551",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "634010551",
"telephone_number": "573-248-5115",
"fax_number": "573-248-5196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 HOSPITAL DR",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "634016887",
"telephone_number": "573-248-5115",
"fax_number": "573-248-5196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICKELS",
"first_name": "JESSICA",
"middle_name": "NICHOLE",
"credential": "RNFA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-04",
"last_updated": "2023-11-06",
"certification_date": "2023-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MO",
"license": "2023040437",
"primary": false
},
{
"code": "163WR0006X",
"taxonomy_group": "",
"desc": "Registered Nurse, Registered Nurse First Assistant",
"state": "MO",
"license": "2013025149",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MO",
"license": "2023040437",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MO",
"license": "2023040437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hannibal, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.