Individual provider Active NPI

Amy Michelle Donovan

  • Family Nurse Practitioner
  • Stanberry, MO
National Provider Identifier
1215809793
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2025012732 Issued in MO
Practice address
202 E Main St
Stanberry, MO 64489-1358
Phone
(660) 783-2192
Fax
(660) 783-2616
NPI assigned
Sep 23, 2025
Last updated
Nov 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 2025012732 MO Primary

Addresses

Primary practice location

202 E Main St
Stanberry, MO 64489-1358

Mailing address

202 E Main St
Stanberry, MO 64489-1358
Phone (660) 783-2192

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
I20251110003096 MO Practitioner - Nurse Practitioner 6204326937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

202 E Main St
Mosaic Family Care Stanberry
Stanberry, MO 64489-1358
Phone (660) 783-2192

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025012732MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Medical Center Association Inc Single Specialty CurrentSince Nov 3, 2025 Accepting new patients
Northwest Medical Center Association, Inc. Single Specialty CurrentSince Nov 3, 2025 Accepting new patients

Locations

705 N College St
Albany, MO 64402
Phone (660) 726-3941

202 E Main St
Stanberry, MO 64489
Phone (660) 783-2092

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, 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": "1758585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1215809793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E MAIN ST",
            "city": "STANBERRY",
            "state": "MO",
            "postal_code": "644891358",
            "telephone_number": "660-783-2192",
            "fax_number": "660-783-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E MAIN ST",
            "city": "STANBERRY",
            "state": "MO",
            "postal_code": "644891358",
            "telephone_number": "660-783-2192",
            "fax_number": "660-783-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "AMY",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-23",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025012732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanberry, MO

Sources for this page

Verify at the official NPI Registry.