NPIMap

Individual provider Active NPI

Martha R. Mustion, F.N.P.

  • Family Nurse Practitioner
  • Maryville, MO
National Provider Identifier
1205830601
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
096048 Issued in MO
Practice address
114 E South Hills Dr
Maryville, MO 64468-2659
Phone
(660) 562-2525
Fax
(660) 562-4303
NPI assigned
Jun 13, 2005
Last updated
Jan 23, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 096048 MO Primary
Family Nurse Practitioner 363LF0000X 107099 IA

Addresses

Primary practice location

114 E South Hills Dr
Maryville, MO 64468-2659

Mailing address

114 E South Hills Dr
Maryville, MO 64468-2659
Phone (660) 562-2525

Other identifiers 4

IdentifierTypeStateIssuer
598277101MedicaidMO
0634568MedicaidIA
425906310MedicaidMO
1126946MedicaidIA

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
I20100331000329 MO Practitioner - Nurse Practitioner 3476689233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mosaic Medical Center - MaryvilleGroup PAC ID 3678813896, shared by 8 NPIs, 76 clinicians
SSM Regional Health ServicesGroup PAC ID 8921917352, shared by 13 NPIs, 165 clinicians

Practice addresses (Care Compare)

2016 S Main St
Maryville, MO 64468-2655
Phone (660) 562-2525

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Missouri State University Past Accepting new patients
Mosaic Medical Center - Maryville Past Accepting new patients

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 3

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1205830601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E SOUTH HILLS DR",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682659",
            "telephone_number": "660-562-2525",
            "fax_number": "660-562-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E SOUTH HILLS DR",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682659",
            "telephone_number": "660-562-2525",
            "fax_number": "660-562-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTION",
        "first_name": "MARTHA",
        "middle_name": "R.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "096048",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "107099",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "598277101",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0634568",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425906310",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1126946",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, MO

Sources for this page

Verify at the official NPI Registry.