Individual provider Active NPI

Michelle Catherine Baumhoer

  • Family Nurse Practitioner
  • Jefferson City, MO
National Provider Identifier
1194451450
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2022014278 Issued in MO
Practice address
3400 W Truman Blvd
Jefferson City, MO 65109-5712
Phone
(573) 636-2181
Fax
(573) 636-3851
NPI assigned
Jul 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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 2022014278 MO Primary

Addresses

Primary practice location

3400 W Truman Blvd
Jefferson City, MO 65109-5712

Mailing address

3400 W Truman Blvd
Jefferson City, MO 65109-5712

Other practice location 1

3405 W Truman Blvd Ste 210
Jefferson City, MO 65109-5861
Phone (573) 261-6226

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
I20220831002988 MO Practitioner - Nurse Practitioner 9931583572 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022014278MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospices of America LLC Family CurrentSince Aug 22, 2022 Accepting new patients
Community Hospices of America, LLC Family CurrentSince Aug 22, 2022 Accepting new patients

Locations

3405 W Truman Blvd
Ste 210
Jefferson City, MO 65109
Phone (573) 261-6226

707 E Briggs Dr
#B
Macon, MO 63552
Phone (660) 385-4400

5780 Osage Beach Pkwy
Osage Beach, MO 65065
Phone (573) 348-1566

10 Cadillac Dr
Ste 400
Brentwood, TN 37027
Phone (615) 637-9163

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1194451450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W TRUMAN BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W TRUMAN BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095712",
            "telephone_number": "573-636-2181",
            "fax_number": "573-636-3851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3405 W Truman Blvd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Jefferson City",
            "state": "MO",
            "postal_code": "651095861",
            "country_code": "US",
            "telephone_number": "573-261-6226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUMHOER",
        "first_name": "MICHELLE",
        "middle_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-28",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2022014278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.