Individual provider Active NPI

Lucretia Page Halfacre, FNP-C

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1295503852
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023001559 Issued in MO
Practice address
4049 S Campbell Ave
Springfield, MO 65807-5303
Phone
(417) 890-5550
NPI assigned
Dec 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 2023001559 MO Primary

Addresses

Primary practice location

4049 S Campbell Ave
Springfield, MO 65807-5303

Mailing address

PO Box 505673
Saint Louis, MO 63150-5673

Other practice location 1

3800 S National Ave Ste 400
Springfield, MO 65807-5272
Phone (000) 000-0000

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
I20231229001627 MO Practitioner - Nurse Practitioner 6507216751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 1254248917, 336 clinicians

Practice addresses (Care Compare)

3800 S National Ave
Suite 400
Springfield, MO 65807-5272
Phone (417) 875-3000

3801 S National
Suite 900
Springfield, MO 65807-5210
Phone (417) 875-3000

Hospital & facility affiliations

  • Cox Medical Centers Hospital, Springfield, MO, CCN 260040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Dec 19, 2024 Accepting new patients
Lester E Cox Medical Centers CurrentSince Dec 19, 2024 Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients

Locations

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

3800 S National Ave
Ste 400
Springfield, MO 65807
Phone (417) 269-9482

1000 E Primrose St
Ste 360
Springfield, MO 65807
Phone (417) 269-4037

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 3

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": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1295503852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505673",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4049 S CAMPBELL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075303",
            "telephone_number": "417-890-5550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 S National Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658075272",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALFACRE",
        "first_name": "LUCRETIA",
        "middle_name": "PAGE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-13",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023001559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.