Chaffee Family Care LLC – Family Nurse Practitioner

Key facts

NPI: 1669946869
Entity type: Organization (NPI type 2)
Primary specialty: Family Nurse Practitioner 363LF0000X
Legal business name: CHAFFEE FAMILY CARE LLC
Practice address: 206 S Main St
Chaffee, MO 63740-1002
Phone: (573) 475-7071
Fax: (573) 475-7237
NPI assigned: Jan 22, 2019
Organization subpart: No

Authorized official

Name: Misty Wilhite, NP
Title: Owner
Phone: (573) 475-7071

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Misty Dawn Wilhite, APRN, FNP-BC Family Nurse Practitioner · Chaffee, MO · NPI 1750897096

Medicare reassignment MO

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
26D2279112	Chaffee Family Care, LLC 206 South Main St, Chaffee, MO 63740	Certificate of waiver	Mar 28, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MO

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20190207001544	MO	Part B Supplier - Clinic/Group Practice	4981942471	Receives reassigned benefits from 1 practitioner Practice locations: Patton, MO; Cape Girardeau, MO; Marble Hill, MO; Fredericktown, MO; Chaffee, MO; 1205 S Mount Auburn Rd, MO

National Provider Directory

Locations

9651 State Highway 72
Patton, MO 63662
Phone (573) 866-2003

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner Group: 193400000X SINGLE SPECIALTY GROUP	363LF0000X			Yes

Addresses

Primary practice location

206 S Main St
Chaffee, MO 63740-1002

Mailing address

206 S Main St
Chaffee, MO 63740-1002
Phone (573) 475-7071

Other providers in Chaffee, MO

All providers in Chaffee, MO · Family Nurse Practitioner in Missouri

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2023. 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.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.