Active NPI
Molly J Omohundro, APRN
- Family Nurse Practitioner
- Jefferson City, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2017043235
- Practice address
- 3605 Country Club Dr
Jefferson City, MO 65109-1070 - Phone
- (573) 634-4878
- Fax
- (573) 636-3045
- NPI assigned
- Nov 20, 2017
- Last updated
- Jun 28, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2017043235 | MO | Primary |
Addresses
Primary practice location
3605 Country Club Dr
Jefferson City, MO 65109-1070
Mailing address
PO Box 104240
Jefferson City, MO 65110-4240
Phone (573) 635-5264
Other practice location 1
One Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-8091
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 420050202 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 80.23 of 100
- Quality
- 58.17
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.92
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017043235 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Curators of the University of Missouri | Current | Accepting new patients | |
| Liberty Hospital Emergency Medicine Physicians, LLC | Current | Accepting new patients | |
| Curators of the University of Missouri | Current | Accepting new patients | |
| Shawnee Mission Medical Center, Inc. | Current | Accepting new patients | |
| Shawnee Mission Medical Center, Inc. | Current | Accepting new patients | |
| New Liberty Hospital Coporation | Past | Accepting new patients |
Locations
7315 E Frontage Rd
Ste 202
Merriam, KS 66204
1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568
404 N Keene St
Columbia, MO 65201
Phone (573) 875-9000
1241 W Stadium Blvd
Jefferson Cty, MO 65109
Phone (573) 556-5771
2525 Glenn Hendren Dr
Liberty, MO 64068
Phone (816) 781-7200
Organizations & group practices 6
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.
-
- Emergency Medicine Physician
- Liberty, MO
- NPI 1336646736
-
- Multi-Specialty Clinic/Center
- Columbia, MO
- NPI 1235126921
-
dba AdventHealth Centra Care
- Urgent Care Clinic/Center
- Shawnee, KS
- NPI 1942317854
-
dba University Physicians Specialty Care Associates
- Durable Medical Equipment & Medical Supplies
- Columbia, MO
- NPI 1356963201
-
dba AdventHealth Imaging Center Roeland Park
- Radiology Clinic/Center
- Roeland Park, KS
- NPI 1578178521
-
dba Liberty Hospital Emergency Physicians
- Emergency Medicine Physician
- Liberty, MO
- NPI 1245054295
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656374400000",
"number": "1366956963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 104240",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651104240",
"telephone_number": "573-635-5264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3605 COUNTRY CLUB DR",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651091070",
"telephone_number": "573-634-4878",
"fax_number": "573-636-3045"
}
],
"practiceLocations": [
{
"address_1": "One Hospital Dr",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "MO",
"postal_code": "652120001",
"country_code": "US",
"telephone_number": "573-882-8091",
"fax_number": "573-884-1902",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OMOHUNDRO",
"first_name": "MOLLY",
"middle_name": "J",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-20",
"last_updated": "2022-06-28",
"certification_date": "2022-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2017043235",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "420050202",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.
- 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.