Individual provider Active NPI

Jennifer Lang, APN, CNM

  • Advanced Practice Midwife
  • Cape Girardeau, MO
National Provider Identifier
1891160164
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
20788 Issued in TN
Practice address
1723 Broadway St Ste 315
Cape Girardeau, MO 63701-4556
Phone
(573) 388-4846
Fax
(573) 388-7635
NPI assigned
Dec 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 20788 TN Primary

Addresses

Primary practice location

1723 Broadway St Ste 315
Cape Girardeau, MO 63701-4556

Mailing address

PO Box 1068
Sikeston, MO 63801-1068
Phone (573) 471-0330

Other identifiers 1

IdentifierTypeStateIssuer
1891160164MedicaidMO

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170524001254 MO Practitioner - Certified Nurse Midwife (CNM) 9931402393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
University of Cincinnati College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Missouri Hospital Physicians LLCGroup PAC ID 9133024334, 206 clinicians

Practice addresses (Care Compare)

1111 N Mount Auburn Rd
Cape Girardeau, MO 63701-3437
Phone (573) 339-1101

Hospital & facility affiliations

  • Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
20788TNMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Paige Gernt LLC Current Accepting new patients
Michael S Pippin MD PC Current Accepting new patients
Southeast Missouri Hospital Physicians, LLC CurrentSince Nov 1, 2018 Accepting new patients
Christine Pham PLLC Current Accepting new patients
Southeast Hospital Past Accepting new patients

Locations

650 S Mount Auburn Rd
Ste 200
Cape Girardeau, MO 63703
Phone (573) 339-1101

1111 N Mount Auburn Rd
Cpe Girardeau, MO 63701
Phone (573) 332-6000

1723 Broadway St
Ste 315
Cpe Girardeau, MO 63701
Phone (573) 332-0226

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

1012 N Main St
Sikeston, MO 63801
Phone (573) 471-0330

317 N Hickory Ave
Cookeville, TN 38501
Phone (931) 528-7527

Organizations & group practices 5

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 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": "1449792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891160164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1068",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638011068",
            "telephone_number": "573-471-0330",
            "fax_number": "573-481-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 BROADWAY ST STE 315",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014556",
            "telephone_number": "573-388-4846",
            "fax_number": "573-388-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "APN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TN",
            "license": "20788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891160164",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.