Individual provider Active NPI

Jason Fall, FNP

  • Family Nurse Practitioner
  • Osage Beach, MO
National Provider Identifier
1215800370
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2025035513 Issued in MO
Practice address
1075 Nichols Rd
Osage Beach, MO 65065-3093
Phone
(573) 302-8000
NPI assigned
Sep 25, 2025
Last updated
Sep 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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 2025035513 MO Primary

Addresses

Primary practice location

1075 Nichols Rd
Osage Beach, MO 65065-3093

Mailing address

14 Essex CT
Camdenton, MO 65020-2339

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
I20251014003108 MO Practitioner - Nurse Practitioner 5092202044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Regional Health SystemGroup PAC ID 9133026776, 132 clinicians

Practice addresses (Care Compare)

1075 Nichols Rd
Osage Beach, MO 65065-3093
Phone (573) 302-3990

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025035513MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Regional Health System Current Accepting new patients
Lake Regional Health System CurrentSince Dec 1, 2025 Accepting new patients
Lake Regional Health System CurrentSince Dec 1, 2025 Accepting new patients

Locations

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

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 2

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": "1758758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1215800370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 ESSEX CT",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "650202339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 NICHOLS RD",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653093",
            "telephone_number": "573-302-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALL",
        "first_name": "JASON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025035513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Osage Beach, MO

Sources for this page

Verify at the official NPI Registry.