Jill M McGruder, APRN,FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

147615 Issued in MO

Practice address

686 Lester St
Poplar Bluff, MO 63901-5025

Phone

(573) 686-2411

Fax

(573) 686-8452

NPI assigned

Oct 7, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1659606713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 LESTER ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015025",
            "telephone_number": "573-686-2411",
            "fax_number": "573-686-8452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 LESTER ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015025",
            "telephone_number": "573-686-2411",
            "fax_number": "573-686-8452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRUDER",
        "first_name": "JILL",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "APRN,FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-07",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "147615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659606713",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martin McDonald, D.O.
• Robert A McDonald, LCSW
• Stacy McElhaney
• David M McFadden, MD
• Priscilla McGonigal
• Yasmine Monique McGuire
• Joanne McIntosh
• Josie Ann McIntosh
• Kaden Douglas McIrvin
• Melanie Darlene McKay

• Family Nurse Practitioner in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.