Judith Medley, MSN, RN, FNP, CPNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

086052 Issued in MO

Practice address

315 W Mulberry
Pilot Knob, MO 63663

Phone

(573) 546-0602

Fax

(573) 546-0624

NPI assigned

Jul 17, 2006

Last updated

Jul 21, 2022By 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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

Locations

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.

• Big Springs Medical Association

  dba Missouri Highlands Health Care

  • Federally Qualified Health Center (FQHC)
  • Van Buren, MO
  • NPI 1225045321
  Medicare reassignment NPD
• Big Springs Medical Association

  dba Missouri Highlands Health Care

  • Federally Qualified Health Center (FQHC)
  • Poplar Bluff, MO
  • NPI 1972466233
  NPD
• BC Missouri Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Farmington, MO
  • NPI 1396760062

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1356368989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157",
            "city": "ELLINGTON",
            "state": "MO",
            "postal_code": "636380157",
            "telephone_number": "573-663-2313",
            "fax_number": "573-663-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W MULBERRY",
            "city": "PILOT KNOB",
            "state": "MO",
            "postal_code": "63663",
            "telephone_number": "573-546-0602",
            "fax_number": "573-546-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLEY",
        "first_name": "JUDITH",
        "credential": "MSN, RN, FNP, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "086052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423134865",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Mathis, M.D.
• Robert Wayne Lefebvre, L.C.S.W.
• Emily Sue Leslie, RDH
• Madison Medical Center Stockhoff Memorial Nursing Home
• Meadowbrook Residential Care
• Johnny Franklin Miller, CRADC
• Jessica Dawn Nichols, FNP
• Ozark Valleys Community Services, Inc. (OVCS, Inc.)
• Ian Pelletier, DO
• Amy Phillips, RDH

• Nurse Practitioner in Pilot Knob, MO
• Providers in Pilot Knob, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.