Individual provider Active NPI

Alyssa Lynn Jensen

  • Primary Care Nurse Practitioner
  • Golden City, MO
National Provider Identifier
1811869340
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
2025028308 Issued in MO
Practice address
403 Main St
Golden City, MO 64748
Phone
(417) 537-4311
NPI assigned
Sep 23, 2025
Last updated
Nov 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 2025028308 MO Primary

Addresses

Primary practice location

403 Main St
Golden City, MO 64748

Mailing address

29 NW 1St LN
Lamar, MO 64759-8105

Other practice location 1

29 NW 1st Ln
Lamar, MO 64759-8105
Phone (417) 681-5266

Other names 1

  • Alyssa Canady Former name

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
I20251023002188 MO Practitioner - Nurse Practitioner 7810485539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barton County Memorial HospitalGroup PAC ID 2365333234, 19 clinicians
CBCH LLCGroup PAC ID 6406116797, 19 clinicians
Cox Barton County HospitalGroup PAC ID 8820329782, 30 clinicians

Practice addresses (Care Compare)

29 NW 1St LN
Lamar, MO 64759-8105

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025028308MOMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cox Barton County Hospital CurrentSince Nov 24, 2025 Accepting new patients
Cox Barton County Hospital CurrentSince Nov 24, 2025 Accepting new patients
Cox Barton County Hospital CurrentSince Sep 28, 2025 Accepting new patients
Barton County Memorial Hospital Past Accepting new patients

Locations

29 NW 1st Ln
Lamar, MO 64759
Phone (417) 681-5266

403 N Main St
Salem, MO 65560
Phone (417) 537-4311

Organizations & group practices 4

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 1

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": "1758585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1811869340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 NW 1ST LN",
            "city": "LAMAR",
            "state": "MO",
            "postal_code": "647598105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 MAIN ST",
            "city": "GOLDEN CITY",
            "state": "MO",
            "postal_code": "64748",
            "telephone_number": "417-537-4311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 NW 1st Ln",
            "address_purpose": "LOCATION",
            "city": "Lamar",
            "state": "MO",
            "postal_code": "647598105",
            "country_code": "US",
            "telephone_number": "417-681-5266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "ALYSSA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-23",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2025028308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "CANADY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Golden City, MO

Sources for this page

Verify at the official NPI Registry.