Individual provider Active NPI

Amy Harrell, APN

  • Family Nurse Practitioner
  • Jefferson City, MO
National Provider Identifier
1811338767
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2013017567 Issued in MO
Practice address
1500 Southwest Blvd
Suite B
Jefferson City, MO 65109-2472
Phone
(537) 635-6350
Fax
(573) 644-6657
NPI assigned
Jul 8, 2013
Last updated
Apr 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2013017567 MO
Family Nurse Practitioner 363LF0000X 2013017567 MO Primary

Addresses

Primary practice location

1500 Southwest Blvd
Suite B
Jefferson City, MO 65109-2472

Mailing address

1500 Southwest Blvd
Suite B
Jefferson City, MO 65109-2472
Phone (537) 635-6350

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
I20140122000872 MO Practitioner - Nurse Practitioner 7719115641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-4141

Hospital & facility affiliations

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

State licenses

LicenseStateTypeSpecialty
2013017567MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Services of Memphis, P.C. Nurse Practitioner CurrentSince Jan 1, 2016 Accepting new patients
The Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1500 Southwest Blvd
Ste B
Jefferson Cty, MO 65109
Phone (573) 635-1577

1505 Southwest Blvd
Jefferson Cty, MO 65109
Phone (573) 634-2620

1705 Christy Dr
Ste 201
Jefferson Cty, MO 65101
Phone (573) 635-0051

3308 W Edgewood Dr
Ste B
Jefferson Cty, MO 65109
Phone (573) 644-6999

5325 Faraon St
Saint Joseph, MO 64506
Phone (816) 271-3500

901 Kidwell Dr
Versailles, MO 65084
Phone (573) 378-4666

Organizations & group practices 3

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": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1811338767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 SOUTHWEST BLVD",
            "address_2": "SUITE B",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092472",
            "telephone_number": "537-635-6350",
            "fax_number": "573-644-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SOUTHWEST BLVD",
            "address_2": "SUITE B",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092472",
            "telephone_number": "537-635-6350",
            "fax_number": "573-644-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "AMY",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2013017567",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013017567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.