Andrea Earlywine, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2001024627 Issued in MO

Practice address

2100 Forum Blvd Ste C-2
Columbia, MO 65203-5436

Phone

(573) 447-7456

Fax

(573) 447-7457

NPI assigned

Jun 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2021 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mind Matters LLC

  • Psychiatry Physician
  • Columbia, MO
  • NPI 1285194613
  NPD (past)

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1679778617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 WEAVER DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652030888",
            "telephone_number": "573-228-0466",
            "fax_number": "573-447-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 FORUM BLVD STE C-2",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035436",
            "telephone_number": "573-447-7456",
            "fax_number": "573-447-7457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLYWINE",
        "first_name": "ANDREA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2001024627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679778617",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marissa Claire Earles, RBT
• Bridget P. Early, M.D.
• Elizabeth K. 'Susie' Early, M.D.
• Jeffrey K Early, PA-C
• Shania Early, PHARMD
• Ease Healthcare
• Easter Seals Midwest
• Ollie Danielle Easter, L.C.S.W.
• Gary D Eaton, DO
• Katherine Eaton

• Psychiatric/Mental Health Nurse Practitioner in Columbia, MO
• Providers in Columbia, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.