Sandra K Headrick, A.P.R.N.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

128892 Issued in MO

Practice address

600 Blues Lake Pkwy
Rolla, MO 65401-8022

Phone

(573) 364-5719

Fax

(573) 364-6493

NPI assigned

Nov 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pcrmc Medical Group IncGroup PAC ID 1557454063, 113 clinicians

Phelps County Regional Medical CenterGroup PAC ID 2860391158, 111 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Rolla, MO, CCN 267098
• Phelps Health Home Health and Hospice Home health agency, Rolla, MO, CCN 267555
• Phelps County Regional Medical Center Hospital, Rolla, MO, CCN 260017
• Salem Memorial District Hospital Hospital, Salem, MO, CCN 261318

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Pcrmc Medical Group, Inc

  • Clinic/Center
  • Rolla, MO
  • NPI 1124237227
  Medicare reassignment Care Compare group NPD
• Phelps County Regional Medical Center

  • General Acute Care Hospital
  • Rolla, MO
  • NPI 1891766051
  Medicare reassignment Care Compare group NPD
• Phelps County Regional Medical Center

  • Rural Health Clinic/Center
  • Rolla, MO
  • NPI 1366066037
  NPD
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Missouri Home Care of Rolla, Inc.

  • Home Health Agency
  • Rolla, MO
  • NPI 1366495384
  Care Compare affiliation
• Pcrmc-Health Services, Inc.

  • Home Health Agency
  • Rolla, MO
  • NPI 1952304578
  Care Compare affiliation
• Phelps County Regional Medical Center

  • Rural Health Clinic/Center
  • Salem, MO
  • NPI 1194077701

  Hospital

  Care Compare affiliation
• Phelps County Regional Medical Center

  • Rehabilitation Hospital Unit
  • Rolla, MO
  • NPI 1346287455
  Care Compare affiliation
• Phelps County Regional Medical Center

  • General Acute Care Hospital
  • Rolla, MO
  • NPI 1891766051
  Care Compare affiliation
• Salem Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Salem, MO
  • NPI 1134199417
  Care Compare affiliation
• Salem Memorial Hospital

  • Critical Access Hospital
  • Salem, MO
  • NPI 1639177561
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1891786414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 W SCENIC RIVERS BLVD",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655602840",
            "telephone_number": "573-729-5533",
            "fax_number": "573-202-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BLUES LAKE PKWY",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654018022",
            "telephone_number": "573-364-5719",
            "fax_number": "573-364-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADRICK",
        "first_name": "SANDRA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "128892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Rolla, MO
• Providers in Rolla, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.