Taylor Rae Altenthal, APRN
Individual provider Active NPI Family Nurse Practitioner · Sikeston, MO
NPI 1811548530 · NPPES record last updated Jun 16, 2023
Key facts
- NPI
- 1811548530
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2019025833 (MO)
- Practice address
- 200 Pine St
Sikeston, MO 63801-3258 - Phone
- (573) 472-8850
- Fax
- (573) 472-4050
- NPI assigned
- Sep 24, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Cincinnati College of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southeast Missouri Health Network
Practice addresses (Care Compare)
200 Southland Dr
Sikeston, MO 63801-4403
Phone (573) 472-1770
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220930002874 | MO | Practitioner - Nurse Practitioner | 3577949361 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Missouri Health Network | Current |
Accepting new patients | |
| Southeast Missouri Health Network | Current |
Accepting new patients | |
| Southeast Missouri Health Network | Current | Accepting new patients |
Locations
6738 State Highway 77
Benton, MO 63736
Phone (573) 313-2500
6724 State Highway 77
Benton, MO 63736
Phone (573) 545-4191
741 S Walnut St
Bernie, MO 63822
Phone (573) 293-6836
109 E 5th St
Caruthersville, MO 63830
Phone (573) 359-9803
500 Russell St
Kennett, MO 63857
Phone (573) 717-1332
655 US Highway 61
New Madrid, MO 63869
Phone (573) 545-4200
310 US Highway 61
New Madrid, MO 63869
Phone (573) 688-2161
835 W Murray Ln
Sikeston, MO 63801
Phone (573) 472-8808
200 Southland Dr
Sikeston, MO 63801
Phone (573) 472-1770
200 Pine St
Sikeston, MO 63801
Phone (573) 313-2500
Interoperability endpoints
- taylor.fuwell.1@14764.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2019025833 | MO | Yes |
Addresses
Primary practice location
200 Pine St
Sikeston, MO 63801-3258
Mailing address
6738 State Highway 77
Benton, MO 63736-8238
Other names
- Taylor Rae Fuwell
Other providers in Sikeston, MO
- Allen Home Care Services Inc
- Allen Home Care Services, Inc
- Allen Home Care Services, Inc.
- Allen Home Care Services, Inc.
- Alliance Rehab & Medical Equipment
- Always There-in Home Care, LLC
- Muhammad Zaeghum Aman
- Americare at la Bonne Maison Assisted Living LLC
- Kaylee Anderson
- Angel Wings Medical Transit LLC
All providers in Sikeston, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.