Laurell A Conder, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2019022745 Issued in MO

Practice address

100 Main St
Gideon, MO 63848

Phone

(573) 448-3800

Fax

(573) 448-8909

NPI assigned

Jun 25, 2019

Last updated

Feb 3, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO, AR2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McPherson Medical and Diagnostic LLCGroup PAC ID 5698773539, 88 clinicians

T W Wagner IncGroup PAC ID 1153359096, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Great River Medical Center Hospital, Blytheville, AR, CCN 040069

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• McPherson Medical & Diagnostic, LLC

  dba Malden Family Clinic and Diagnostic

  • Clinic/Center
  • Malden, MO
  • NPI 1003407883
  Medicare reassignment Care Compare group NPD
• T W Wagner Inc

  dba Wagner Medical Clinic

  • Family Medicine Physician
  • Manila, AR
  • NPI 1720183031
  Medicare reassignment Care Compare group NPD
• McPherson Medical & Diagnostic, LLC

  • Family Medicine Physician
  • Kennett, MO
  • NPI 1124679774
  NPD
• McPherson Medical & Diagnostic, LLC

  • Family Medicine Physician
  • Gideon, MO
  • NPI 1497189864
  NPD
• T W Wagner Inc

  • Rural Health Clinic/Center
  • Lepanto, AR
  • NPI 1114734969
  NPD
• McPherson Medical & Diagnostic, LLC

  • Family Medicine Physician
  • Steele, MO
  • NPI 1164440806
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mississippi County Hospital System

  dba Great River Medical Center

  • General Acute Care Hospital
  • Blytheville, AR
  • NPI 1316180748
  Care Compare affiliation

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1255992897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W COMMERCIAL ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638571100",
            "telephone_number": "573-717-1072",
            "fax_number": "573-559-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAIN ST",
            "city": "GIDEON",
            "state": "MO",
            "postal_code": "63848",
            "telephone_number": "573-448-3800",
            "fax_number": "573-448-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDER",
        "first_name": "LAURELL",
        "middle_name": "A",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "122452",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019022745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420074761",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Micah N. Breece
• Community Wide CDS LLC
• Community Wide in Home LLC
• Community Wide in Home LLC
• Courageous Findings LLC
• Everybodys Home LLC
• Gideon 37 School District
• Gideon Care Center, Inc
• Emily Harris, PA-C

• Family Nurse Practitioner in Gideon, MO
• Providers in Gideon, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.