Elizabeth Pemberton, AGNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

2016012215 Issued in MO

Practice address

306 Harbour Pointe Dr
Grover, MO 63040-1937

Phone

(314) 308-5424

NPI assigned

Aug 30, 2016

Last updated

Aug 30, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, CA, WI, TX4 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 4

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

NP Health of Mo LLCGroup PAC ID 4183047053, 17 clinicians

Comprehensive Rehab Consultants PLLCGroup PAC ID 6800220682, 251 clinicians

Practice addresses (Care Compare)

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.

• Comprehensive Rehab Consultants PLLC

  dba Comprehensive Rehab Consultants LLC

  • Physical Medicine & Rehabilitation Physician
  • Middle River, MD
  • NPI 1710529771

  TX, WI

  Medicare reassignment Care Compare group NPD
• NP Health of Mo LLC

  • Physical Medicine & Rehabilitation Physician
  • Morton Grove, IL
  • NPI 1477170959

  MO

  Medicare reassignment Care Compare group NPD
• Omar Osman MD PC

  dba Comprehensive Rehab Consultants PC

  • Physical Medicine & Rehabilitation Physician
  • Morton Grove, IL
  • NPI 1669192472

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1295281236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 HARBOUR POINTE DR",
            "city": "GROVER",
            "state": "MO",
            "postal_code": "630401937",
            "telephone_number": "314-308-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 HARBOUR POINTE DR",
            "city": "GROVER",
            "state": "MO",
            "postal_code": "630401937",
            "telephone_number": "314-308-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "ELIZABETH",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2016012215",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2016012215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald S Lowther, MD
• Raymond Joseph Marey, D. D. S.
• Lucas J Meyer, D.M.D.
• Marla M Olish, PNP
• Optimal Health Chiropractic LLC
• Karl Robert Peterson, APRN CNM
• Professional Healthcare Services, LLC
• Stephanie Smith, D.C.
• Andrew Warner, M.ED, PLPC
• Judy M Wylie, LPC

• Gerontology Nurse Practitioner in Grover, MO
• Providers in Grover, MO by specialty
• Gerontology Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.