Jacqueline Fornelli, DNP, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2020036180 Issued in MO

Practice address

932 E 34TH St
Joplin, MO 64804-3932

Phone

(417) 347-8310

NPI assigned

Dec 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, KS2 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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Freeman-Oak Hill Health SystemGroup PAC ID 8325942253, 385 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Freeman Health System - Freeman West Hospital, Joplin, MO, CCN 260137
• Cox Barton County Hospital Hospital, Lamar, MO, CCN 261325
• Nevada Regional Medical Center Hospital, Nevada, MO, CCN 260061
• Girard Medical Center Hospital, Girard, KS, CCN 171376
• Freeman Neosho Hospital Hospital, Neosho, MO, CCN 261331

Merit-based Incentive Payment System (MIPS)

Final score

81.37 of 100Reported as group

Quality

60.15

Promoting interoperability

100

Improvement activities

40

Cost

77.74

Merit-based Incentive Payment System (MIPS)

Final score

74.07 of 100Reported as group

Quality

45.41

Promoting interoperability

97

Improvement activities

40

Cost

70.66

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Freeman-Oak Hill Health System

  • Multi-Specialty Clinic/Center
  • Joplin, MO
  • NPI 1679517023

  KS

  Medicare reassignment Care Compare group NPD
• Heartland Kidney Physicians LLC

  • Nephrology Physician
  • Carthage, MO
  • NPI 1982978037
  Medicare reassignment NPD

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

• Cox Barton County Hospital

  • Critical Access Hospital
  • Lamar, MO
  • NPI 1922514629
  Care Compare affiliation
• Freeman Neosho Hospital

  • Critical Access Hospital
  • Neosho, MO
  • NPI 1598873796
  Care Compare affiliation
• Freeman-Oak Hill Health System

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Webb City, MO
  • NPI 1114394228

  Hospital

  Care Compare affiliation
• Freeman-Oak Hill Health System

  • General Acute Care Hospital
  • Joplin, MO
  • NPI 1265546048
  Care Compare affiliation
• Nevada City Hospital

  • Surgery Physician
  • Nevada, MO
  • NPI 1164754859

  Hospital

  Care Compare affiliation
• Nevada City Hospital

  • Surgery Physician
  • Nevada, MO
  • NPI 1205164753

  Hospital

  Care Compare affiliation
• Nevada City Hospital

  • General Practice Physician
  • Nevada, MO
  • NPI 1689904336

  Hospital

  Care Compare affiliation
• Nevada City Hospital

  • Rural Acute Care Hospital
  • Nevada, MO
  • NPI 1942283866
  Care Compare affiliation
• Hospital District No 1 Crawford County

  • Critical Access Hospital
  • Girard, KS
  • NPI 1578505095
  Care Compare affiliation

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1265029912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648033810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 E 34TH ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043932",
            "telephone_number": "417-347-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNELLI",
        "first_name": "JACQUELINE",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-29",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2020036180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Ann Marie Ford, MD
• Lauren Nicole Ford
• Taylor Nicole Ford
• Brandon Fordham, D.O.
• Michael Cameron Forhan
• Arianna Forst
• Hope E Fortuck
• Amanda Shaun Foster, WHNP-BC
• Joshua J Foster
• Julia L Foster, NP

• Nurse Practitioner in Joplin, MO
• Providers in Joplin, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.