Individual provider Active NPI

Mollie Blume, FNP-C

  • Family Nurse Practitioner
  • Cape Girardeau, MO
National Provider Identifier
1790582922
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2025004202 Issued in MO
Practice address
3 Doctors Park
Cape Girardeau, MO 63703-4927
Phone
(573) 334-7748
NPI assigned
Feb 26, 2025
Last updated
Feb 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 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 2025004202 MO Primary

Addresses

Primary practice location

3 Doctors Park
Cape Girardeau, MO 63703-4927

Mailing address

460 Apple CRST
Burfordville, MO 63739-9139
Phone (573) 450-4828

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
I20250604003027 MO Practitioner - Nurse Practitioner 2860901477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Missouri Medical College, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cape Girardeau Urology Associates IncGroup PAC ID 6608967716, 12 clinicians

Practice addresses (Care Compare)

3 Doctors Park
Cape Girardeau, MO 63703-4927
Phone (573) 334-7748

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Girardeau Urology Associates, Inc. CurrentSince May 5, 2025 Accepting new patients

Locations

3 Doctors Park
Cpe Girardeau, MO 63703
Phone (573) 334-7748

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc06039_capegirardeauuroassoc

Organizations & group practices 1

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1740528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1790582922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 APPLE CRST",
            "city": "BURFORDVILLE",
            "state": "MO",
            "postal_code": "637399139",
            "telephone_number": "573-450-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034927",
            "telephone_number": "573-334-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUME",
        "first_name": "MOLLIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-26",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025004202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.