Theresa Rene Maxwell, RN, MSN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

096655 Issued in MO

Practice address

1011 E Saint Maartens Dr
Saint Joseph, MO 64506-2993

Phone

(816) 232-0185

Fax

(816) 364-6225

NPI assigned

Jun 6, 2007

Last updated

Sep 25, 2013By 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 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Digestive Health Specialists LLCGroup PAC ID 9739494832, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mosaic Life Care at St Joseph Hospital, Saint Joseph, MO, CCN 260006
• Mosaic Medical Center - Maryville Hospital, Maryville, MO, CCN 261340
• Hiawatha Community Hospital Hospital, Hiawatha, KS, CCN 171341

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Digestive Health Specialists, LLC

  • Gastroenterology Physician
  • Independence, MO
  • NPI 1801286844
  Medicare reassignment Care Compare group NPD
• Image Specialties, L.L.C.

  • Family Nurse Practitioner
  • Saint Joseph, MO
  • NPI 1629356142
  NPD (past) Authorized official

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

• Heartland Regional Medical Center

  dba Mosaic Life Care at St Joseph Medical Center

  • General Acute Care Hospital
  • Saint Joseph, MO
  • NPI 1437259694
  Care Compare affiliation
• Mosaic Medical Center - Maryville

  • Critical Access Hospital
  • Maryville, MO
  • NPI 1265906663
  Care Compare affiliation
• Hiawatha Hospital Association Inc

  dba Amberwell Hiawatha

  • Critical Access Hospital
  • Hiawatha, KS
  • NPI 1255421210
  Care Compare affiliation

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1780887109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 N LEONARD RD",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645064024",
            "telephone_number": "816-232-0185",
            "fax_number": "816-364-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 E SAINT MAARTENS DR",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062993",
            "telephone_number": "816-232-0185",
            "fax_number": "816-364-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "THERESA",
        "middle_name": "RENE",
        "credential": "RN, MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "096655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "624003109",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brent Allen Matthews, F-NP
• Adam C. Matthias, D.D.S.
• Morris C Matthias, CRNA
• Craig Mattox, D.C.
• Dixie Leah Mattthews
• Chinakasiobi Mbata, DDS
• Brittany Shea McCan, FNP-BC
• Karen Rose McClanahan, PTA
• Harold McClellan, LCSW
• Karen McClure

• Family Nurse Practitioner in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.