NPIMap

Individual provider Active NPI

Amy Lallathin, NP

  • Gerontology Nurse Practitioner
  • Branson, MO
National Provider Identifier
1194291054
Registry record updated Nov 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
2018040401 Issued in MO
Practice address
448 State Highway 248 Ste 120
Branson, MO 65616-3725
Phone
(417) 337-5000
NPI assigned
Oct 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2014002993 MO
Gerontology Nurse Practitioner 363LG0600X 2018040401 MO Primary

Addresses

Primary practice location

448 State Highway 248 Ste 120
Branson, MO 65616-3725

Mailing address

448 State Highway 248 Ste 120
Branson, MO 65616-3725
Phone (417) 337-5000

Other practice location 1

18598 Business 13
Branson West, MO 65737-9659
Phone (417) 272-8497

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
I20181212001775 MO Practitioner - Nurse Practitioner 5496099889 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
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)

448 State Hwy 248
Suite 120
Branson, MO 65616-3725
Phone (417) 337-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014002993MOMDRegistered Nurse
2018040401MOMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Dec 3, 2018 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Dec 3, 2018 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Dec 3, 2018 Accepting new patients

Locations

448 State Highway 248
Ste 120
Branson, MO 65616
Phone (417) 337-5000

940 W Mount Vernon St
Ste 100
Nixa, MO 65714
Phone (417) 724-5220

18598 Business 13
Reeds Spring, MO 65737
Phone (417) 272-1785

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

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

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

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

Interoperability endpoints

  • Direct secure messaging: alallathin390487@directc.mercy.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1194291054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 STATE HIGHWAY 248 STE 120",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656163725",
            "telephone_number": "417-337-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 STATE HIGHWAY 248 STE 120",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656163725",
            "telephone_number": "417-337-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18598 Business 13",
            "address_purpose": "LOCATION",
            "city": "Branson West",
            "state": "MO",
            "postal_code": "657379659",
            "country_code": "US",
            "telephone_number": "417-272-8497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LALLATHIN",
        "first_name": "AMY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2014002993",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2018040401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

Verify at the official NPI Registry.