Active NPI
Becky Cannaday, FNP
- Family Nurse Practitioner
- Poplar Bluff, MO
National Provider Identifier
1609848662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 088262
- Practice address
- 1500 N Westwood Blvd
Poplar Bluff, MO 63901-3318 - Phone
- (573) 686-4151
- NPI assigned
- Feb 3, 2006
- Last updated
- Dec 13, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 088262 | MO | Primary |
Addresses
Primary practice location
1500 N Westwood Blvd
Poplar Bluff, MO 63901-3318
Mailing address
1500 N Westwood Blvd
Poplar Bluff, MO 63901-3318
Phone (573) 686-4151
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 505222703 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 088262 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Psychiatric Services Inc | Past | Accepting new patients | |
| Advanced Psychiatric Services | Past | Accepting new patients | |
| Ozarks Medical Center | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatry Physician
- Sullivan, MO
- NPI 1457303877
-
- Psychiatry Physician
- Festus, MO
- NPI 1154372464
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386892800000",
"number": "1609848662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 N WESTWOOD BLVD",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639013318",
"telephone_number": "573-686-4151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 N WESTWOOD BLVD",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639013318",
"telephone_number": "573-686-4151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNADAY",
"first_name": "BECKY",
"name_prefix": "Ms.",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-03",
"last_updated": "2013-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "088262",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "505222703",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Poplar Bluff, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.