Individual provider Active NPI

Micheala Stewart, APRN, FNP-C

  • Family Nurse Practitioner
  • Mountain Grove, MO
National Provider Identifier
1548005671
Registry record updated Jun 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2024024221 Issued in MO
Practice address
100 W 17TH St Ste D
Mountain Grove, MO 65711-1060
Phone
(417) 349-4100
NPI assigned
Jun 29, 2024
Last updated
Jun 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2024024221 MO Primary

Addresses

Primary practice location

100 W 17TH St Ste D
Mountain Grove, MO 65711-1060

Mailing address

10966 Dogwood Rd
Mountain Grove, MO 65711-2195
Phone (417) 299-0698

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
I20240812003343 MO Practitioner - Nurse Practitioner 2466990205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spurling and White LLCGroup PAC ID 2365788213, 2 clinicians

Practice addresses (Care Compare)

100 W 17TH St D
Grove Family Care
Mountain Grove, MO 65711-1060
Phone (417) 349-4100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spurling and White LLC Family CurrentSince Jul 3, 2024 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

100 W 17th St
Ste D
Mountain Grv, MO 65711
Phone (417) 349-4100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719619200000",
    "number": "1548005671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10966 DOGWOOD RD",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657112195",
            "telephone_number": "417-299-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W 17TH ST STE D",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111060",
            "telephone_number": "417-349-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MICHEALA",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-29",
        "last_updated": "2024-06-29",
        "certification_date": "2024-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2024024221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Grove, MO

Sources for this page

Verify at the official NPI Registry.