Jeanne Pauline Abbott, DO
Individual provider Active NPI Preventive Medicine/Occupational Environmental Medicine Physician · Osage Beach, MO
NPI 1669467221 · NPPES record last updated Mar 28, 2013
Key facts
- NPI
- 1669467221
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X
- License
- 2005027545 (MO)
- Practice address
- 54 Hospital Dr
Suite 102
Osage Beach, MO 65065-3050 - Phone
- (573) 348-8045
- Fax
- (573) 348-8046
- NPI assigned
- Sep 20, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Owned or controlled facilities with NPI records 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Baptist Homes of Arcadia Valley |
Skilled nursing facility | Corporate Director | Oct 28, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051025000004 | MO | Practitioner - Preventive Medicine | 2769460112 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005027545 | MO | MD | Preventive Medicine/Occupational Environmental Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Regional Health System | Current | Accepting new patients | |
| Lake Regional Health System | Current |
Accepting new patients | |
| Lake Regional Health System | Current |
Accepting new patients | |
| Memorial Hospital | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
755 Cowan Dr
Lebanon, MO 65536
Phone (417) 532-2805
54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772
54 Hospital Dr
Ste 102
Osage Beach, MO 65065
Phone (573) 348-0826
54 Hospital Dr
#102
Osage Beach, MO 65065
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | 2005027545 | MO | Yes |
Addresses
Primary practice location
54 Hospital Dr
Suite 102
Osage Beach, MO 65065-3050
Mailing address
54 Hospital Dr
Osage Beach, MO 65065-3050
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207466103 | Medicaid | MO |
Other providers in Osage Beach, MO
- Access Dental Services LP
- Active Care Physical Therapy & Spine Center, LLC
- Add Life Chiropractic & Wellness Center, Inc
- Baron Scott Adkins
- Ads Osage Beach LP
All providers in Osage Beach, MO · Preventive Medicine/Occupational Environmental Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.