Individual provider Active NPI

Joy Nneka Eke, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Gladstone, MO
National Provider Identifier
1285752865
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2021029690 Issued in MO
Practice address
5604 NE Antioch Rd
Gladstone, MO 64119-2327
Phone
(660) 372-1313
Fax
(660) 372-1339
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 53-45794-092 KS
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2021029690 MO Primary

Addresses

Primary practice location

5604 NE Antioch Rd
Gladstone, MO 64119-2327

Mailing address

1513 Union Ave Ste 2500
Moberly, MO 65270-9412
Phone (660) 372-1313

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
I20220803001822 MO Practitioner - Nurse Practitioner 9931123882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Hills Behavioral Health SolutionsGroup PAC ID 5597192823, 6 clinicians
Samuel O Fadare MD PAGroup PAC ID 3072615525, 2 clinicians

Practice addresses (Care Compare)

1513 Union Ave
Suite 2500
Moberly, MO 65270-9412
Phone (660) 372-1313

5604 NE Antioch Rd
Gladstone, MO 64119-2327
Phone (660) 372-1313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-45794-092KSMDPsychiatric/Mental Health Nurse Practitioner
2021029690MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel O Fadare, MD, PA Psychiatric/Mental Health CurrentSince Jun 18, 2022 Accepting new patients
Oak Hills Behavioral Health Solutions CurrentSince Aug 28, 2022 Accepting new patients

Locations

5604 N Antioch Rd
Gladstone, MO 64119
Phone (816) 533-5057

1513 Union Ave
Moberly, MO 65270
Phone (660) 263-6611

1513 Union Ave
Ste 2500
Moberly, MO 65270
Phone (660) 372-1313

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.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1285752865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 UNION AVE STE 2500",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652709412",
            "telephone_number": "660-372-1313",
            "fax_number": "660-372-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 NE ANTIOCH RD",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641192327",
            "telephone_number": "660-372-1313",
            "fax_number": "660-372-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKE",
        "first_name": "JOY",
        "middle_name": "NNEKA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "53-45794-092",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2021029690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, MO

Sources for this page

Verify at the official NPI Registry.