NPIMap

Individual provider Active NPI

Amy Creason, FNP

  • Family Nurse Practitioner
  • Brookfield, MO
National Provider Identifier
1235610304
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018021097 Issued in MO
Practice address
130 E Lockling St
Brookfield, MO 64628-2337
Phone
(660) 258-1050
Fax
(660) 258-1052
NPI assigned
Aug 27, 2018
Last updated
Nov 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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 2018021097 MO Primary

Addresses

Primary practice location

130 E Lockling St
Brookfield, MO 64628-2337

Mailing address

10635 Delta Dr
Browning, MO 64630-9775
Phone (660) 946-4594

Other identifiers 1

IdentifierTypeStateIssuer
2018021097OtherMOMISSOURI STATE BOARD OF NURSING

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
I20180911003410 MO Practitioner - Nurse Practitioner 6406106509 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sullivan County Memorial HospitalGroup PAC ID 7810973252, shared by 6 NPIs, 17 clinicians

Practice addresses (Care Compare)

Courthouse
Milan, MO 63556

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018021097MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sullivan County Memorial Hospital CurrentSince Mar 1, 2023 Accepting new patients
Sullivan County Memorial Hospital CurrentSince Nov 1, 2025 Accepting new patients
Sullivan County Memorial Hospital CurrentSince Mar 1, 2023 Accepting new patients
General John J Pershing Memorial Hospital Association CurrentSince Sep 1, 2018 Accepting new patients
Sullivan County Memorial Hospital Past Accepting new patients

Locations

130 E Lockling St
Brookfield, MO 64628
Phone (660) 258-1050

101 E Hayward St
Meadville, MO 64659
Phone (660) 938-4213

210 N Market St
Milan, MO 63556
Phone (660) 265-4456

630 W 3rd St
Milan, MO 63556
Phone (660) 265-1077

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/sulliva-d2785c8f

Organizations & group practices 5

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 6

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": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1235610304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10635 DELTA DR",
            "city": "BROWNING",
            "state": "MO",
            "postal_code": "646309775",
            "telephone_number": "660-946-4594",
            "fax_number": "660-258-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E LOCKLING ST",
            "city": "BROOKFIELD",
            "state": "MO",
            "postal_code": "646282337",
            "telephone_number": "660-258-1050",
            "fax_number": "660-258-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREASON",
        "first_name": "AMY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018021097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI STATE BOARD OF NURSING",
            "identifier": "2018021097",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, MO

Sources for this page

Verify at the official NPI Registry.