Individual provider Active NPI

Alicia Eagleburger, RMA

  • Technician
  • Nixa, MO
National Provider Identifier
1710795000
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
TechnicianTaxonomy code 374700000X
License
2847341 Issued in MO
Practice address
1919 Fitz LN
Nixa, MO 65714-8459
Phone
(417) 233-1262
Fax
(417) 233-1260
NPI assigned
Dec 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Technician 374700000X 2847341 MO Primary

Addresses

Primary practice location

1919 Fitz LN
Nixa, MO 65714-8459

Mailing address

1919 Fitz LN
Nixa, MO 65714-8459
Phone (417) 233-1262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Medical Assistant

State licenses

LicenseStateTypeSpecialty
2847341MOMDTechnician

NPI Registry JSON

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

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1710795000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 FITZ LN",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657148459",
            "telephone_number": "417-233-1262",
            "fax_number": "417-233-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 FITZ LN",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657148459",
            "telephone_number": "417-233-1262",
            "fax_number": "417-233-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGLEBURGER",
        "first_name": "ALICIA",
        "name_prefix": "Mrs.",
        "credential": "RMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "MO",
            "license": "2847341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nixa, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.