Individual provider Active NPI

Gloria Akorfa Kpenu, NP

  • Family Nurse Practitioner
  • Maryville, MO
National Provider Identifier
1700759495
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2025015230 Issued in MO
Practice address
2016 S Main St
Maryville, MO 64468-2655
Phone
(660) 562-2525
Fax
(660) 562-7993
NPI assigned
Sep 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2025015230 MO Primary

Addresses

Primary practice location

2016 S Main St
Maryville, MO 64468-2655

Mailing address

2016 S Main St
Maryville, MO 64468-2655
Phone (660) 562-2525

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
I20251208000477 MO Practitioner - Nurse Practitioner 1557854577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Regional Health ServicesGroup PAC ID 8921917352, shared by 13 NPIs, 165 clinicians

Practice addresses (Care Compare)

2016 S Main St
Maryville, MO 64468-2655
Phone (660) 562-2525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2025015230MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Medical Center - Maryville Family CurrentSince Nov 18, 2025 Accepting new patients
Mosaic Medical Center - Maryville CurrentSince Nov 18, 2025 Accepting new patients

Locations

2016 S Main St
Maryville, MO 64468
Phone (660) 562-2525

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1700759495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 S MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682655",
            "telephone_number": "660-562-2525",
            "fax_number": "660-562-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 S MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682655",
            "telephone_number": "660-562-2525",
            "fax_number": "660-562-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KPENU",
        "first_name": "GLORIA",
        "middle_name": "AKORFA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025015230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, MO

Sources for this page

Verify at the official NPI Registry.