Individual provider Active NPI

Alicia Larae Lee, MSN, NP-C

  • Family Nurse Practitioner
  • Hannibal, MO
National Provider Identifier
1891449625
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2021023511 Issued in MO
Practice address
6500 Hospital Dr
Hannibal, MO 63401-6890
Phone
(573) 629-3300
Fax
(573) 629-3314
NPI assigned
Feb 10, 2022
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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 2021023511 MO Primary

Addresses

Primary practice location

6500 Hospital Dr
Hannibal, MO 63401-6890

Mailing address

PO Box 1239
Hannibal, MO 63401-1239
Phone (573) 406-5888

Other names 1

  • Alicia Larae Lake 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
I20220217002019 MO Practitioner - Nurse Practitioner 0941693832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6500 Hospital Dr
Hannibal, MO 63401-6890
Phone (573) 248-1300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2021023511MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hannibal Regional Healthcare System Inc CurrentSince Mar 3, 2022 Accepting new patients
Hannibal Regional Healthcare System, Inc CurrentSince Mar 3, 2022 Accepting new patients
Hannibal Regional Healthcare System, Inc Past Accepting new patients

Locations

6000 Hospital Dr
Hannibal, MO 63401
Phone (573) 248-5460

6500 Hospital Dr
Hannibal, MO 63401
Phone (573) 629-3400

Interoperability endpoints

  • Direct secure messaging: alicialake@hrmg.allscriptsdirect.net
  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602

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 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": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1891449625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634011239",
            "telephone_number": "573-406-5888",
            "fax_number": "573-248-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016890",
            "telephone_number": "573-629-3300",
            "fax_number": "573-629-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ALICIA",
        "middle_name": "LARAE",
        "credential": "MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021023511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "LAKE",
            "middle_name": "LARAE",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.