Individual provider Active NPI

Teresa Kathleen Brandon, FNP

  • Family Nurse Practitioner
  • Cape Girardeau, MO
National Provider Identifier
1629345392
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2011038004 Issued in MO
Practice address
3250 Gordonville Rd Ste 301
Cape Girardeau, MO 63703-5095
Phone
(573) 334-9641
Fax
(573) 331-4130
NPI assigned
Nov 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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 2011038004 MO Primary

Addresses

Primary practice location

3250 Gordonville Rd Ste 301
Cape Girardeau, MO 63703-5095

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

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
I20120210000725 MO Practitioner - Nurse Practitioner 3779740253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

150 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049

2130 E Jackson Blvd
Saint Francis Clinic Jackson
Jackson, MO 63755-2907
Phone (573) 243-3115

24 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Cape Girardeau, MO, CCN 260183

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011038004MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center Current Accepting new patients
Cape Laboratory & Pathology, LC Current Accepting new patients
Saint Francis Medical Center CurrentSince Jul 1, 2016 Accepting new patients
Saint Francis Medical Center CurrentSince Jul 1, 2016 Accepting new patients

Locations

211 Saint Francis Dr
Ste 1143
Cape Girardeau, MO 63703
Phone (573) 331-5587

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

1702 N Kingshighway St
Cpe Girardeau, MO 63701
Phone (573) 339-0483

3250 Gordonville Rd
Ste 301
Cpe Girardeau, MO 63703
Phone (573) 334-9641

2130 E Jackson Blvd
Jackson, MO 63755
Phone (573) 243-3115

Interoperability endpoints

  • Direct secure messaging: tbrandon10681@surescripts.sfmc.net

Organizations & group practices 4

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 2

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": "1322092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1629345392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 GORDONVILLE RD STE 301",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035095",
            "telephone_number": "573-334-9641",
            "fax_number": "573-331-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "TERESA",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-24",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2011038004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.