Individual provider Active NPI

Olivia Jenae Cumley, FNP

  • Family Nurse Practitioner
  • Bolivar, MO
National Provider Identifier
1194211664
Registry record updated Jul 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018021610 Issued in MO
Practice address
1240 N Butterfield Rd
Bolivar, MO 65613-3016
Phone
(417) 326-6021
Fax
(417) 326-6347
NPI assigned
Jul 7, 2018
Last updated
Jul 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2018

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 2018021610 MO Primary

Addresses

Primary practice location

1240 N Butterfield Rd
Bolivar, MO 65613-3016

Mailing address

1500 N Oakland Ave
Bolivar, MO 65613-3011
Phone (417) 839-9327

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
I20180719000330 MO Practitioner - Nurse Practitioner 6507113701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizens Memorial HealthcareGroup PAC ID 4183528169, 144 clinicians

Practice addresses (Care Compare)

Bolivar, MO 65613
Phone (417) 328-6631

1155 W Parkview
Bolivar, MO 65613-7800

1155 W Parkview St
Bolivar, MO 65613-7800

1500 N Oakland Ave
CMH Diabetes
Bolivar, MO 65613-3099
Phone (417) 328-6040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018021610MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Citizens Memorial Healthcare CurrentSince Jul 9, 2018 Accepting new patients
Citizens Memorial Healthcare CurrentSince Jul 9, 2018 Accepting new patients
Citizens Memorial Healthcare Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1155 W Parkview St
Ste 2D
Bolivar, MO 65613
Phone (417) 777-2663

1240 N Butterfield Rd
Bolivar, MO 65613
Phone (417) 326-6021

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

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 1

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": "1530921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530921600000",
    "number": "1194211664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-839-9327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 N BUTTERFIELD RD",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133016",
            "telephone_number": "417-326-6021",
            "fax_number": "417-326-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMLEY",
        "first_name": "OLIVIA",
        "middle_name": "JENAE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-07",
        "last_updated": "2018-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018021610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

Verify at the official NPI Registry.