Individual provider Active NPI

Deana James, NP

  • Nurse Practitioner
  • Hannibal, MO
National Provider Identifier
1487343810
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2023013504 Issued in MO
Practice address
163 Medical Dr
Hannibal, MO 63401-6884
Phone
(573) 719-1818
NPI assigned
May 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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 2023013504 MO Primary

Addresses

Primary practice location

163 Medical Dr
Hannibal, MO 63401-6884

Mailing address

163 Medical Dr
Hannibal, MO 63401-6884
Phone (573) 719-1818

Other practice location 1

8676 County Road 346
Taylor, MO 63471-2215
Phone (573) 719-1818

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
I20240221001522 MO Practitioner - Nurse Practitioner 2668816323 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Dermatology and Spa LLCGroup PAC ID 7214282227, 5 clinicians

Practice addresses (Care Compare)

163 Medical Dr
Suite 1
Hannibal, MO 63401-6884
Phone (217) 919-7217

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Dermatology & Spa LLC CurrentSince Dec 24, 2023 Accepting new patients
Integrated Dermatology of Northeast Missouri LLC CurrentSince Apr 1, 2025 Accepting new patients

Locations

163 Medical Dr
Ste 1
Hannibal, MO 63401
Phone (217) 919-7217

163 Medical Dr
Hannibal, MO 63401
Phone (573) 248-3900

8676 County Road 346
Taylor, MO 63471
Phone (573) 719-1818

8480 Highway 24
Taylor, MO 63471
Phone (573) 719-1818

Organizations & group practices 2

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": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1487343810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 MEDICAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016884",
            "telephone_number": "573-719-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 MEDICAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016884",
            "telephone_number": "573-719-1818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8676 County Road 346",
            "address_purpose": "LOCATION",
            "city": "Taylor",
            "state": "MO",
            "postal_code": "634712215",
            "country_code": "US",
            "telephone_number": "573-719-1818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMES",
        "first_name": "DEANA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2023013504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.