Individual provider Active NPI

Julie Ann Dotzler, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fulton, MO
National Provider Identifier
1679381685
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2024049527 Issued in MO
Practice address
581 Commons Dr
Fulton, MO 65251-1408
Phone
(573) 582-1234
Fax
(573) 582-1212
NPI assigned
Dec 23, 2024
Last updated
Jun 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2024049527 MO Primary

Addresses

Primary practice location

581 Commons Dr
Fulton, MO 65251-1408

Mailing address

340 Kelley Pkwy
Mexico, MO 65265-3811
Phone (573) 582-1234

Other practice location 1

340 Kelley Pkwy
Mexico, MO 65265-3811
Phone (573) 582-1234

Other identifiers 1

IdentifierTypeStateIssuer
420154652MedicaidMO

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
I20250812000349 MO Practitioner - Nurse Practitioner 3678071404 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Root Awakening LLC Psychiatric/Mental Health CurrentSince Feb 1, 2026 Accepting new patients
Centerpointe Hospital of Columbia, LLC CurrentSince May 12, 2025 Accepting new patients

Locations

1201 International Dr
Columbia, MO 65202
Phone (573) 615-2001

105 S Weber Ave
Salisbury, MO 65281
Phone (660) 388-5001

6100 Tower Cir
Ste 1000
Franklin, TN 37067
Phone (615) 454-7459

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1679381685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653811",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 COMMONS DR",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652511408",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 Kelley Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mexico",
            "state": "MO",
            "postal_code": "652653811",
            "country_code": "US",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOTZLER",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-23",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2024049527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420154652",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, MO

Sources for this page

Verify at the official NPI Registry.