Individual provider Active NPI

Hunter Nicole Damron, PA-C

  • Physician Assistant
  • Columbia, MO
National Provider Identifier
1467283556
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2025001668 Issued in MO
Practice address
1601 E Broadway Ste 240
Columbia, MO 65201-8022
Phone
(573) 815-8145
Fax
(573) 815-3832
NPI assigned
Aug 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2025001668 MO Primary

Addresses

Primary practice location

1601 E Broadway Ste 240
Columbia, MO 65201-8022

Mailing address

1601 E Broadway Ste 240
Columbia, MO 65201-8022
Phone (573) 815-8145

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
I20250128004455 MO Practitioner - Physician Assistant 9830628387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
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)

1600 E Broadway
Columbia, MO 65201-5844
Phone (573) 815-8000

1600 E Broadway Box 50 Attn Stephanie Windsor
Columbia, MO 65201-5844

1601 E Broadway
Suite 240
Columbia, MO 65201-8022
Phone (573) 815-8145

1701 E Broadway
Columbia, MO 65201-8018

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2025001668MOMDPhysician Assistant

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1467283556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E BROADWAY STE 240",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018022",
            "telephone_number": "573-815-8145",
            "fax_number": "573-815-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E BROADWAY STE 240",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018022",
            "telephone_number": "573-815-8145",
            "fax_number": "573-815-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMRON",
        "first_name": "HUNTER",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2025001668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.