Individual provider Active NPI

Antoinette M Metzner, FNP-C

  • Family Nurse Practitioner
  • Columbia, MO
National Provider Identifier
1295447886
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2009017347 Issued in MO
Practice address
1600 E Broadway
Columbia, MO 65201-5897
Phone
(573) 815-2700
Fax
(573) 815-3693
NPI assigned
Dec 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 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 2009017347 MO Primary

Addresses

Primary practice location

1600 E Broadway
Columbia, MO 65201-5897

Mailing address

420 Marinas Ave
Ashland, MO 65010-8220
Phone (573) 777-2680

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL boone.health Direct

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
I20230111003037 MO Practitioner - Nurse Practitioner 5294105029 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

1600 E Broadway
Columbia, MO 65201-5844
Phone (573) 815-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2009017347MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boone Physician Services, LLC CurrentSince Feb 15, 2023 Accepting new patients
General John J Pershing Memorial Hospital Association CurrentSince May 1, 2023 Accepting new patients
General John J Pershing Memorial Hospital Association CurrentSince May 1, 2023 Accepting new patients

Locations

130 E Lockling St
Brookfield, MO 64628
Phone (660) 258-1050

1600 E Broadway
Ste 110
Columbia, MO 65201
Phone (573) 875-8838

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1295447886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 MARINAS AVE",
            "city": "ASHLAND",
            "state": "MO",
            "postal_code": "650108220",
            "telephone_number": "573-777-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E BROADWAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015897",
            "telephone_number": "573-815-2700",
            "fax_number": "573-815-3693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZNER",
        "first_name": "ANTOINETTE",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2009017347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "boone.health",
            "affiliation": "N",
            "endpointDescription": "Communication between colleagues",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1600 E Broadway",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652015897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.