NPIMap

Individual provider Active NPI

Ivy C Tobin

  • Acute Care Nurse Practitioner
  • Hannibal, MO
National Provider Identifier
1801553938
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2021047405 Issued in MO
Practice address
6500 Hospital Dr
Hannibal, MO 63401-6890
Phone
(573) 629-3500
Fax
(573) 629-3314
NPI assigned
Nov 23, 2021
Last updated
May 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2021047405 MO Primary
Registered Nurse 163W00000X 2013009873 MO

Addresses

Primary practice location

6500 Hospital Dr
Hannibal, MO 63401-6890

Mailing address

PO Box 1239
Hannibal, MO 63401-1239
Phone (573) 629-3500

Other practice location 1

One Hospital Dr
Columbia, MO 65212-0001
Phone (573) 884-3278

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
I20220211000725 MO Practitioner - Nurse Practitioner 2466845672 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
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)

1235 E Cherokee St
2C SPRG Cardiothoracic Surgery Heart
Springfield, MO 65804-2203
Phone (417) 820-3960

6000 Hospital Dr PO Box
Suite 1257
Hannibal, MO 63401-1257

6500 Hospital Dr
Hannibal, MO 63401-6890

PO Box
Suite 1257
Hannibal, MO 63401-1257
Phone (573) 248-5460

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013009873MOMDRegistered Nurse
2021047405MOMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hannibal Regional Healthcare System Inc CurrentSince Jun 10, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Dec 5, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Dec 5, 2024 Accepting new patients
Midwest Heart & Vascular Specialists, LLC CurrentSince Sep 1, 2025 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Dec 5, 2024 Accepting new patients
Hannibal Regional Healthcare System, Inc Past Accepting new patients

Locations

12200 W 106th St
Ste 315
Overland Park, KS 66215
Phone (913) 348-4202

5721 W 119th St
Shawnee Msn, KS 66209
Phone (913) 253-3000

6000 Hospital Dr
Hannibal, MO 63401
Phone (573) 248-5460

6000 Hospital Dr
#1257
Hannibal, MO 63401
Phone (573) 248-5460

6500 Hospital Dr
Hannibal, MO 63401
Phone (573) 629-3400

19550 E 39th St S
Ste 215
Independence, MO 64057
Phone (816) 461-6837

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

2330 E Meyer Blvd
Ste 505
Kansas City, MO 64132
Phone (913) 267-1943

2000 SE Blue Pkwy
Ste 250
Lees Summit, MO 64063
Phone (816) 795-8200

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

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

1235 E Cherokee St
Ste 2C
Springfield, MO 65804
Phone (417) 820-3960

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

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
  • Direct secure messaging: itobin507396@direct-ehr-ssmhc.com
  • Direct secure messaging: ivytobin@hrmg.allscriptsdirect.net

Organizations & group practices 6

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 11

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": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1801553938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634011239",
            "telephone_number": "573-629-3500",
            "fax_number": "573-629-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016890",
            "telephone_number": "573-629-3500",
            "fax_number": "573-629-3314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652120001",
            "country_code": "US",
            "telephone_number": "573-884-3278",
            "fax_number": "573-884-0437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "IVY",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-23",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2021047405",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2013009873",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.