Individual provider Active NPI

Vanessa Adams, NP-C

  • Family Nurse Practitioner
  • Poplar Bluff, MO
National Provider Identifier
1316486202
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017003057 Issued in MO
Practice address
225 Physicians Park
Ste 203
Poplar Bluff, MO 63901-3935
Phone
(573) 686-4750
Fax
(573) 686-4753
NPI assigned
Feb 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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 2017003057 MO Primary

Addresses

Primary practice location

225 Physicians Park
Ste 203
Poplar Bluff, MO 63901-3935

Mailing address

PO Box 699
Poplar Bluff, MO 63902-0699
Phone (573) 686-4750

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
I20170406001227 MO Practitioner - Nurse Practitioner 5092091058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Office PCGroup PAC ID 0244392009, 4 clinicians

Practice addresses (Care Compare)

1600 W Harper St
Poplar Bluff, MO 63901-4119
Phone (573) 686-4750

225 Physicians Park
Poplar Bluff, MO 63901-3930
Phone (573) 686-4750

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Office PC CurrentSince Mar 13, 2017 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

225 Physicians Park
Ste 203
Poplar Bluff, MO 63901
Phone (573) 686-4750

1600 W Harper St
Poplar Bluff, MO 63901
Phone (573) 785-6699

225 Physicians Park
Ste 304
Poplar Bluff, MO 63901
Phone (573) 686-2411

Interoperability endpoints

  • Direct secure messaging: vadams@elitespecialtycare.emadirect.md

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1316486202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639020699",
            "telephone_number": "573-686-4750",
            "fax_number": "573-686-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 PHYSICIANS PARK",
            "address_2": "STE 203",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013935",
            "telephone_number": "573-686-4750",
            "fax_number": "573-686-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "VANESSA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017003057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.