NPIMap

Individual provider Active NPI

Cherrie L Pickett, FNP

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1710227038
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2013004122 Issued in MO
Practice address
3045 W Republic Rd
Springfield, MO 65807-4682
Phone
(417) 889-0056
NPI assigned
Feb 23, 2013
Last updated
Jul 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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 2013004122 MO Primary

Addresses

Primary practice location

3045 W Republic Rd
Springfield, MO 65807-4682

Mailing address

3045 W Republic Rd
Springfield, MO 65807-4682
Phone (417) 889-0056

Other identifiers 3

IdentifierTypeStateIssuer
431560263OtherMOTRICARE
1710227038MedicaidMO
P01177925OtherMORR MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130426000469 MO Practitioner - Nurse Practitioner 4587800156 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1605 Martin Springs Dr
Rolla, MO 65401-2980

1965 S Fremont Ave
2950 MC Federal Medical Center
Springfield, MO 65804-2201
Phone (417) 862-7041

1965 S Fremont Ave
370 MC Urology S Fremont
Springfield, MO 65804-2284
Phone (417) 820-0300

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

2115 S Fremont Ave
3100 MC Lab and Imaging Services Whiteside
Springfield, MO 65804-2205
Phone (417) 820-3738

3231 S National Ave
Springfield, MO 65807-7304

940 W Mount Vernon St
Nixa, MO 65714-9613

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013004122MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Family CurrentSince Mar 4, 2013 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Mar 4, 2013 Accepting new patients
Mercy Clinic Springfield Communities Family CurrentSince Mar 4, 2013 Accepting new patients
Mercy Hospital Springfield Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Organizations & group practices 5

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1361577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1710227038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3045 W REPUBLIC RD",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658074682",
            "telephone_number": "417-889-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 W REPUBLIC RD",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658074682",
            "telephone_number": "417-889-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "CHERRIE",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-23",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013004122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431560263",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710227038",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P01177925",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.