Alisa Beth Fajkus, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

2024026678 Issued in MO

Practice address

402 W Jefferson St
Kirksville, MO 63501-3407

Phone

(660) 665-3555

NPI assigned

Jul 31, 2023

Last updated

Nov 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

University of Kansas School of Med (KC/Wich/Sal), 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Missouri Health Council IncGroup PAC ID 1658280805, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alisa.fajkus.p1@direct.nmhcinc.nextgenshare.com

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.

• Northeast Missouri Health Council, Inc.

  dba Northeast Family Health Clinics

  • Federally Qualified Health Center (FQHC)
  • Kirksville, MO
  • NPI 1104829498
  Medicare reassignment Care Compare group NPD
• Northeast Missouri Health Council Inc

  dba Memphis Community Health Center

  • Internal Medicine Physician
  • Memphis, MO
  • NPI 1881307155
  NPD
• Northeast Missouri Health Council, Inc.

  dba OB/GYN Specialty Group/Northeast Pediatrics

  • Federally Qualified Health Center (FQHC)
  • Kirksville, MO
  • NPI 1326184334
  NPD

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1689355687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 CROWN DR",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635012548",
            "telephone_number": "660-627-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W JEFFERSON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013407",
            "telephone_number": "660-665-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJKUS",
        "first_name": "ALISA",
        "middle_name": "BETH",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MO",
            "license": "2024026678",
            "primary": true
        },
        {
            "code": "163WX0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, Inpatient",
            "state": "MO",
            "license": "2013025730",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Mae Ernst, FNP
• Sarah Elizabeth Ernst, MSN, FNP-BC
• Tyler O'Neil Eschbach
• Maria Louise Evans, M.D.
• Courtney Everhart, DO, MPH
• Abdel Algani Fanous
• Nicole D Fehr, LPN
• Sharon K Feltman, LPN
• Loutrisha Fernandez
• Lisa Marie Ferrino

• Advanced Practice Midwife in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Advanced Practice Midwife in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.
• Medicare Care Compare (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.