Individual provider Active NPI

Janet M Udelhofen, APRN

  • Adult Health Nurse Practitioner
  • Osage Beach, MO
National Provider Identifier
1447229489
Registry record updated Nov 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2008027316 Issued in MO
Practice address
54 Hospital Dr
Suite 204
Osage Beach, MO 65065-3050
Phone
(573) 348-8045
Fax
(573) 348-8046
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2008

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 A-059614 IA
Adult Health Nurse Practitioner 363LA2200X 2008027316 MO Primary

Addresses

Primary practice location

54 Hospital Dr
Suite 204
Osage Beach, MO 65065-3050

Mailing address

54 Hospital Dr
Osage Beach, MO 65065-3050
Phone (573) 348-8074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008027316MOMDAdult Health Nurse Practitioner
A-059614IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Iowa Clinic, PC Past Accepting new patients
The Iowa Clinic PC PastSince Oct 1, 1995 Accepting new patients
Crain Medical Clinic Past Accepting new patients

Organizations & group practices 3

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227571200000",
    "number": "1447229489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DR",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050",
            "telephone_number": "573-348-8074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DR",
            "address_2": "SUITE 204",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050",
            "telephone_number": "573-348-8045",
            "fax_number": "573-348-8046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDELHOFEN",
        "first_name": "JANET",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A-059614",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2008027316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Osage Beach, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.