Individual provider Active NPI

Angela Sue Neighbors, FNP

  • Nurse Practitioner
  • Saint Robert, MO
National Provider Identifier
1427038686
Registry record updated Oct 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
118093 Issued in MO
Practice address
608 Old Route 66
Saint Robert, MO 65584-3730
Phone
(573) 336-5100
NPI assigned
Jan 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 118093 MO Primary

Addresses

Primary practice location

608 Old Route 66
Saint Robert, MO 65584-3730

Mailing address

608 Old Route 66
Saint Robert, MO 65584-3730
Phone (573) 336-5100

Other practice location 1

1101 W Liberty St
Farmington, MO 63640-1921
Phone (573) 760-8475

Other identifiers 1

IdentifierTypeStateIssuer
429355118MedicaidMO

Other names 1

  • Angela Sue Goodwin Former name

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
I20050314000264 MO Practitioner - Nurse Practitioner 4486612728 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118093MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Oct 23, 2017 Accepting new patients
Advanced Psychiatric Services Inc PastSince Jun 16, 2014 Accepting new patients
Mineral Area Osteopathic Hospital Inc Nurse Practitioner Past Accepting new patients
BC Missouri Emergency Physicians, LLP Nurse Practitioner Past Accepting new patients
Farmington Clinic Company, LLC Past Accepting new patients
Advanced Psychiatric Services Past Accepting new patients
BC Missouri Emergency Physicians, LLP Nurse Practitioner Past Accepting new patients

Locations

608 Old Route 66
Saint Robert, MO 65584
Phone (573) 336-5100

Organizations & group practices 8

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": "1137801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507248000000",
    "number": "1427038686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 OLD ROUTE 66",
            "city": "SAINT ROBERT",
            "state": "MO",
            "postal_code": "655843730",
            "telephone_number": "573-336-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 OLD ROUTE 66",
            "city": "SAINT ROBERT",
            "state": "MO",
            "postal_code": "655843730",
            "telephone_number": "573-336-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 W Liberty St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "MO",
            "postal_code": "636401921",
            "country_code": "US",
            "telephone_number": "573-760-8475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEIGHBORS",
        "first_name": "ANGELA",
        "middle_name": "SUE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-21",
        "last_updated": "2017-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "118093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "429355118",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "GOODWIN",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Robert, MO

Sources for this page

Verify at the official NPI Registry.