Individual provider Active NPI

Cheryl Ann Stallo, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Columbia, MO
National Provider Identifier
1881322600
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2020017998 Issued in MO
Practice address
1701 E Broadway Ste 101
Columbia, MO 65201-8018
Phone
(573) 815-3612
Fax
(573) 815-2985
NPI assigned
Aug 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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 2020017998 MO Primary

Addresses

Primary practice location

1701 E Broadway Ste 101
Columbia, MO 65201-8018

Mailing address

1701 E Broadway Ste 101
Columbia, MO 65201-8018
Phone (573) 815-3612

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
I20221024000305 MO Practitioner - Nurse Practitioner 0941676522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

1701 E Broadway
Suite 101
Columbia, MO 65201-8018
Phone (573) 815-3612

Hospital & facility affiliations

  • Boone Hospital Center Hospital, Columbia, MO, CCN 260068
  • Boone Hospital Center Inpatient rehabilitation facility, Columbia, MO, CCN 26T068

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
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
2020017998MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boone Physician Services, LLC CurrentSince Jan 13, 2025 Accepting new patients

Locations

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

1701 E Broadway
Ste 101
Columbia, MO 65201
Phone (573) 449-1261

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1881322600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 E BROADWAY STE 101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018018",
            "telephone_number": "573-815-3612",
            "fax_number": "573-815-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E BROADWAY STE 101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018018",
            "telephone_number": "573-815-3612",
            "fax_number": "573-815-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLO",
        "first_name": "CHERYL",
        "middle_name": "ANN",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020017998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.