Individual provider Active NPI

Michelle Renee Nash, FNP-BC

  • Family Nurse Practitioner
  • Farmington, MO
National Provider Identifier
1356982896
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2020001739 Issued in MO
Practice address
705 Grand Canyon Dr
Farmington, MO 63640-2161
Phone
(573) 756-8911
Fax
(573) 315-3824
NPI assigned
Oct 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2020001739 MO Primary
Family Nurse Practitioner 363LF0000X 2018035951 MO

Addresses

Primary practice location

705 Grand Canyon Dr
Farmington, MO 63640-2161

Mailing address

PO Box 735378
Chicago, IL 60673-5378

Other practice location 1

1157 Maple St
Farmington, MO 63640
Phone (573) 218-9871

Other practice location 2

330 N State St
Desloge, MO 63601-3093
Phone (573) 431-4449

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
I20230329000919 MO Practitioner - Nurse Practitioner 7214301415 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Missouri Mso LLCGroup PAC ID 3274035035, 2 clinicians

Practice addresses (Care Compare)

1501 Charbonier Rd
Florissant, MO 63031-5308
Phone (212) 734-6621

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018035951MOMDFamily Nurse Practitioner
2020001739MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Partners Care Management LP CurrentSince Mar 6, 2025 Accepting new patients
Karefirst Missouri PC CurrentSince Mar 6, 2023 Accepting new patients
JDS Medical Services PC CurrentSince Jun 7, 2025 Accepting new patients
Missouri Mso LLC CurrentSince Jul 20, 2025 Accepting new patients

Locations

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (410) 967-2097

705 Grand Canyon Dr
Farmington, MO 63640
Phone (573) 756-2750

1501 Charbonier Rd
Florissant, MO 63031
Phone (314) 921-2700

13230 Manchester Rd
Saint Louis, MO 63131
Phone (314) 480-5259

3403 W Mount Vernon St
Springfield, MO 65802
Phone (417) 864-5600

Organizations & group practices 5

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 2

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": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1356982896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735378",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 GRAND CANYON DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636402161",
            "telephone_number": "573-756-8911",
            "fax_number": "573-315-3824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1157 Maple St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "MO",
            "postal_code": "63640",
            "country_code": "US",
            "telephone_number": "573-218-9871",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 N State St",
            "address_purpose": "LOCATION",
            "city": "Desloge",
            "state": "MO",
            "postal_code": "636013093",
            "country_code": "US",
            "telephone_number": "573-431-4449",
            "fax_number": "573-431-2443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NASH",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020001739",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018035951",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

Verify at the official NPI Registry.