Individual provider Active NPI

Corrie Beth Hitzelberger, NP-C

  • Adult Health Nurse Practitioner
  • Cottleville, MO
National Provider Identifier
1164924569
Registry record updated Mar 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2017038952 Issued in MO
Practice address
1309 Commons Cir
Cottleville, MO 63304-6842
Phone
(816) 284-9650
NPI assigned
Mar 2, 2018
Last updated
Mar 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2017038952 MO Primary

Addresses

Primary practice location

1309 Commons Cir
Cottleville, MO 63304-6842

Mailing address

1309 Commons Cir
Cottleville, MO 63304-6842

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180328000951 MO Practitioner - Nurse Practitioner 2365704533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James Cole Physiatry LLCGroup PAC ID 3870976582, 15 clinicians

Practice addresses (Care Compare)

4455 Duncan Ave
Saint Louis, MO 63110-1111
Phone (314) 920-8933

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
James Cole Physiatry LLC CurrentSince Dec 7, 2024 Accepting new patients

Locations

4455 Duncan Ave
Saint Louis, MO 63110
Phone (314) 658-3800

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1519948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519948800000",
    "number": "1164924569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 COMMONS CIR",
            "city": "COTTLEVILLE",
            "state": "MO",
            "postal_code": "633046842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 COMMONS CIR",
            "city": "COTTLEVILLE",
            "state": "MO",
            "postal_code": "633046842",
            "telephone_number": "816-284-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITZELBERGER",
        "first_name": "CORRIE",
        "middle_name": "BETH",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-02",
        "last_updated": "2018-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2017038952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottleville, MO

Sources for this page

Verify at the official NPI Registry.