NPIMap

Individual provider Active NPI

Stephanie Rose Davison, FNP-BC

  • Family Nurse Practitioner
  • Rogersville, MO
National Provider Identifier
1285319491
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023022150 Issued in MO
Practice address
101 S Main St
Rogersville, MO 65742-9357
Phone
(417) 753-9404
Fax
(417) 753-9137
NPI assigned
Jun 16, 2023
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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 2023022150 MO Primary

Addresses

Primary practice location

101 S Main St
Rogersville, MO 65742-9357

Mailing address

101 S Main St
Rogersville, MO 65742-9357
Phone (417) 753-9404

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
I20230620003040 MO Practitioner - Nurse Practitioner 1951769132 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1312 E Lark St
MC Psychiatry Lark
Springfield, MO 65804-7351
Phone (417) 820-8180

1312 N Hwy 5
MC Family Medicine Ava
Ava, MO 65608-5104
Phone (417) 683-4045

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.15 of 100Reported as apm
Quality
88.15
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023022150MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Sep 16, 2024 Accepting new patients
Sgoh Acquisition Inc CurrentSince Jun 19, 2023 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Sep 16, 2024 Accepting new patients
Sgoh Acquisition Inc CurrentSince Jun 19, 2023 Accepting new patients
Mercy Clinic Springfield Communities Family CurrentSince Sep 16, 2024 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1101 Jackson St SW
Gravette, AR 72736
Phone (479) 787-5221

1312 N Highway 5
Ava, MO 65608
Phone (417) 683-4045

106 S Hickory St
Mount Vernon, MO 65712
Phone (417) 466-4110

101 S Main St
Rogersville, MO 65742
Phone (417) 753-9404

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

1312 E Lark St
Springfield, MO 65804
Phone (417) 820-3707

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Organizations & group practices 6

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 9

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": "1686873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1285319491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657429357",
            "telephone_number": "417-753-9404",
            "fax_number": "417-753-9137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657429357",
            "telephone_number": "417-753-9404",
            "fax_number": "417-753-9137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "STEPHANIE",
        "middle_name": "ROSE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-16",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023022150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogersville, MO

Sources for this page

Verify at the official NPI Registry.