Tina R McCorkell, FNP
Individual provider Active NPI Family Nurse Practitioner · Piedmont, MO
NPI 1679558530 · NPPES record last updated Mar 5, 2021
Key facts
- NPI
- 1679558530
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 110399 (MO)
- Practice address
- 420 Piedmont Ave
Piedmont, MO 63957-1024 - Phone
- (573) 223-4233
- Fax
- (573) 223-2136
- NPI assigned
- Dec 13, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 21
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Saint Francis Medical Center
Practice addresses (Care Compare)
150 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049
211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
24 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049
420 Piedmont Ave
Piedmont, MO 63957-1024
Phone (573) 223-4233
48 Doctors Park
Cape Girardeau, MO 63703-4928
Phone (573) 335-8257
70 Doctors Park
Cape Girardeau, MO 63703-4928
Phone (573) 334-6071
Hospital & facility affiliations
- Saint Francis Medical Center
- Poplar Bluff Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 67.5 of 100
- Quality
- 53.06
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 67.07 of 100
- Quality
- 85.4
- Promoting interoperability
- 0
- Improvement activities
- 40
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100127000904 | MO | Practitioner - Nurse Practitioner | 1658413729 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Francis Medical Center | Current |
Accepting new patients | |
| Saint Francis Medical Center | Current | Accepting new patients | |
| Saint Francis Medical Center | Current |
Accepting new patients | |
| Saint Francis Medical Center | Past | Accepting new patients | |
| Kneibert Clinic LLC | Past | Accepting new patients |
Locations
211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000
545 Broadridge Dr
Jackson, MO 63755
Phone (573) 243-1997
420 Piedmont Ave
Piedmont, MO 63957
Phone (573) 223-2526
Interoperability endpoints
- tmccorkell11900@surescripts.sfmc.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 110399 | MO | Yes |
Addresses
Primary practice location
420 Piedmont Ave
Piedmont, MO 63957-1024
Mailing address
PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006013890 | Other | MO | MEDICARE |
Other providers in Piedmont, MO
- Lifes Bridges Inc
- Grete Lovell
- Amy Christine Marler
- Franklin Dewayne Maynard
- Sierra Mays
- Helen Margaret McDonald
- Martha McDonald
- Alisha McFadden
- Jessica McMahan
- Hannah Medler
All providers in Piedmont, 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 Mar 5, 2021. 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.
- Order and Referring (CMS).
- 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.