NPIMap

Organization Active NPI

Community Hospital Association FNP Group

  • Nurse Practitioner
  • Fairfax, MO
National Provider Identifier
1750424693
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
102-48 Issued in MO
Legal business name
COMMUNITY HOSPITAL ASSOCIATION FNP GROUP
Practice address
26136 US Highway 59
Fairfax, MO 64446-9105
Phone
(660) 686-2211
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Authorized official

Name
Julie Jones
Title
Administrator
Phone
(660) 686-2211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 102-48 MO Primary

Addresses

Primary practice location

26136 US Highway 59
Fairfax, MO 64446-9105

Mailing address

405 E Main St
PO Box 107
Fairfax, MO 64446-8155
Phone (660) 686-2211

Other identifiers 2

IdentifierTypeStateIssuer
00594011OtherMOBCBS
540492501MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Community Hospital Association9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

405 E Main St
Fairfax, MO 64446
Phone (660) 686-2211

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571616000000",
    "number": "1750424693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 E MAIN ST",
            "address_2": "PO BOX 107",
            "city": "FAIRFAX",
            "state": "MO",
            "postal_code": "644468155",
            "telephone_number": "660-686-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26136 US HIGHWAY 59",
            "city": "FAIRFAX",
            "state": "MO",
            "postal_code": "644469105",
            "telephone_number": "660-686-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPITAL ASSOCIATION FNP GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2019-10-21",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "660-686-2211"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "102-48",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00594011",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "540492501",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.