Beverly Dawn Schneider, FNP-BC
Individual provider Active NPI Nurse Practitioner · O'Fallon, MO
NPI 1306112388 · NPPES record last updated Sep 11, 2023
Key facts
- NPI
- 1306112388
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 2012007881 (MO)
- Practice address
- 2630 State Highway K
O'Fallon, MO 63368 - Phone
- (636) 240-5454
- NPI assigned
- Mar 23, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy East Ambulatory Services LLC
Practice addresses (Care Compare)
20 The Legends Pkwy
Eureka, MO 63025-3823
Phone (636) 549-8509
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120424000688 | MO | Practitioner - Nurse Practitioner | 0648432401 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2012007881 | MO | |
| Nurse Practitioner | 363L00000X | 2012007881 | MO | Yes |
Addresses
Primary practice location
2630 State Highway K
O'Fallon, MO 63368
Mailing address
2630 State Highway K
O'Fallon, MO 63368
Phone (636) 240-5454
Other practice location 1
1 Southtowne Dr
Potosi, MO 63664-5729
Phone (573) 438-8309
Other practice location 2
20 The Legends Pkwy
Eureka, MO 63025-3823
Phone (636) 549-8509
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Other providers in O'Fallon, MO
- Qi Enterprises
- Michelle Rega
- Matthew E Reyering
- Brett Rough
- Rajiv Sadana
- Laura Michelle Sibley
- Lillie L Smith
- Spectrum Monitoring, LLC
- St Lukes Center for Diagnostic Imaging LLC
- George P. Stachecki
All providers in O'Fallon, MO · Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.