Deann Lois Thompson
Individual provider Active NPI Nurse Practitioner · Ava, MO
NPI 1508039769 · NPPES record last updated Apr 9, 2008
Key facts
- NPI
- 1508039769
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 149792 (MO)
- Practice address
- 120 South West 2ND Avenue
Ava, MO 65608 - Phone
- (417) 683-6790
- Fax
- (417) 683-6770
- NPI assigned
- Apr 9, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 12
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mansfield Clinic Inc
Practice addresses (Care Compare)
304 W Commercial St
Mansfield, MO 65704-9527
Phone (417) 924-3066
PO Box
Suite 865
Ava, MO 65608
Hospital & facility affiliations
- Mercy Hospital Springfield
- Cox Medical Centers
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140313001826 | MO | Practitioner - Nurse Practitioner | 3274797832 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients | |
| Family Walk in Clinic of Mountain Grove Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 149792 | MO | Yes |
Addresses
Primary practice location
120 South West 2ND Avenue
Ava, MO 65608
Mailing address
HC 71 Box 209
Ava, MO 65608-8910
Phone (417) 683-9268
Other names
- Deann Lois Richards
Other providers in Ava, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.