Active NPI
Patricia Alexa Summerford, APRN
- Family Nurse Practitioner
- Mountain View, MO
National Provider Identifier
1669430575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 129188
- Practice address
- 104 East Highway 60
Mountain View, MO 65548-7381 - Phone
- (417) 934-2251
- Fax
- (417) 934-2871
- NPI assigned
- May 2, 2006
- Last updated
- Mar 26, 2014
- Sex
- Female
- Sole proprietor
- No
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 | 129188 | MO | Primary |
Addresses
Primary practice location
104 East Highway 60
Mountain View, MO 65548-7381
Mailing address
PO Box 505164
Saint Louis, MO 63150-5164
Phone (417) 829-4620
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00852026 | Other | MO | PALMETTO GBA/RR MEDICARE |
| 1669430575 | Medicaid | MO | |
| 428643639 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 129188 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
Interoperability endpoints
- psummerford106550@directb.mercy.net
Organizations & group practices 1
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.
-
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": "1146528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395792000000",
"number": "1669430575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 505164",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631505164",
"telephone_number": "417-829-4620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 EAST HIGHWAY 60",
"city": "MOUNTAIN VIEW",
"state": "MO",
"postal_code": "655487381",
"telephone_number": "417-934-2251",
"fax_number": "417-934-2871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMMERFORD",
"first_name": "PATRICIA",
"middle_name": "ALEXA",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-02",
"last_updated": "2014-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "129188",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA/RR MEDICARE",
"identifier": "P00852026",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1669430575",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "428643639",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mountain View, MO
- Amy L Schierling, LPC
- Russell S Schierling, DC
- Spartan Sleep Studies
- St Francis Hospital (St. John's St Francis Hospital)
- St Francis Hospital (St Francis Home Medical Equipment)
- Coralee M. Thacker-Thompson, PNP
- Wal-Mart Stores East LP (Walmart Pharmacy 100871)
- Walgreen Co (Walgreens # 15054)
- Mary Elizabeth Waterhouse, AGNP-BC
- Whetstone Boys Ranch
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.