Individual provider Active NPI

Pamela S. Dubois, APN

  • Family Nurse Practitioner
  • Festus, MO
National Provider Identifier
1801866975
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2012015199 Issued in MO
Practice address
660A S Truman Blvd
Festus, MO 63028-2235
Phone
(636) 931-3800
Fax
(636) 931-3911
NPI assigned
Jan 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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 2012015199 MO Primary

Addresses

Primary practice location

660A S Truman Blvd
Festus, MO 63028-2235

Mailing address

660A S Truman Blvd
Festus, MO 63028-2235
Phone (636) 931-3800

Other identifiers 1

IdentifierTypeStateIssuer
159046758MedicaidAR

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Regional Outpatient Facilities, LLC CurrentSince Oct 1, 2012 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

660 S Truman Blvd
#A
Festus, MO 63028
Phone (636) 206-8049

660A S Truman Blvd
Festus, MO 63028
Phone (636) 206-8049

1125 Main St
Imperial, MO 63052
Phone (636) 206-8051

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1801866975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660A S TRUMAN BLVD",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282235",
            "telephone_number": "636-931-3800",
            "fax_number": "636-931-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660A S TRUMAN BLVD",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282235",
            "telephone_number": "636-931-3800",
            "fax_number": "636-931-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "PAMELA",
        "middle_name": "S.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012015199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159046758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; 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.