Bethany Laurian Douglas, MSN FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2025001784 Issued in MO

Practice address

320 W Mount Vernon Blvd
Mount Vernon, MO 65712-1940

Phone

(417) 461-0056

Fax

(833) 707-1944

NPI assigned

Jan 24, 2025

Last updated

Mar 4, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Circle Maker LLCGroup PAC ID 9133599772, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cox Monett Hospital Hospital, Monett, MO, CCN 261329
• Mercy Hospital Aurora Hospital, Aurora, MO, CCN 261316

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bethany.douglas.1@26271.direct.athenahealth.com

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.

• Circle Maker LLC

  dba Center for Diagnostic Medicine

  • Family Medicine Physician
  • Mount Vernon, MO
  • NPI 1962134114
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cox-Monett Hospital, Inc.

  • Critical Access Hospital
  • Monett, MO
  • NPI 1194757500
  Care Compare affiliation
• Mercy Hospital Aurora

  • Critical Access Hospital
  • Aurora, MO
  • NPI 1467543090
  Care Compare affiliation

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

{
    "created_epoch": "1737676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1306658463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W MOUNT VERNON BLVD",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657121940",
            "telephone_number": "417-461-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W MOUNT VERNON BLVD",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657121940",
            "telephone_number": "417-461-0056",
            "fax_number": "833-707-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "BETHANY",
        "middle_name": "LAURIAN",
        "name_prefix": "Mrs.",
        "credential": "MSN FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-24",
        "last_updated": "2025-03-04",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025001784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Curators University of Mo (Dba Missouri Rehabilitation Center-Physicians Group)
• Derek Curtis, PTA
• Sabrina A Davis, OTR
• Elizabeth Evalyn Dean, D.O.
• Robert J Dieckhoff
• Michael Newman Douglas, RPH
• Thomas G Douglas, NP
• Ramonda Lynn Dugas, NP
• Rolando Sy Dy, M.D.
• Lawrence L. Dybedock, M.D.

• Family Nurse Practitioner in Mount Vernon, MO
• Providers in Mount Vernon, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.