Individual provider Active NPI

Jonathan Daniel Barnes, AGPCNP-BC

  • Nurse Practitioner
  • Columbia, MO
National Provider Identifier
1376915678
Registry record updated Oct 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2015038021 Issued in MO
Practice address
1601 E Broadway
Broadway Medical Plaza 1 Suite 240
Columbia, MO 65201-8020
Phone
(573) 815-7119
NPI assigned
Oct 26, 2015
Last updated
Oct 26, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2015038021 MO Primary
Adult Health Nurse Practitioner 363LA2200X 2015038021 MO
Gerontology Nurse Practitioner 363LG0600X 2015038021 MO

Addresses

Primary practice location

1601 E Broadway
Broadway Medical Plaza 1 Suite 240
Columbia, MO 65201-8020

Mailing address

1601 E Broadway
Broadway Medical Plaza 1 Suite 240
Columbia, MO 65201-8020
Phone (573) 815-7119

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
I20151209002463 MO Practitioner - Nurse Practitioner 4880995265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

1705 E Broadway
Suite 280
Columbia, MO 65201-7185
Phone (573) 815-7119

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1376915678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E BROADWAY",
            "address_2": "BROADWAY MEDICAL PLAZA 1 SUITE 240",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018020",
            "telephone_number": "573-815-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E BROADWAY",
            "address_2": "BROADWAY MEDICAL PLAZA 1 SUITE 240",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018020",
            "telephone_number": "573-815-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "JONATHAN",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2015038021",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2015038021",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2015038021",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.