Individual provider Active NPI

Robin Wollard, FNP

  • Family Nurse Practitioner
  • Sedalia, MO
National Provider Identifier
1902136369
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
089371 Issued in MO
Practice address
4400 S Limit Ave
Suite B
Sedalia, MO 65301-1179
Phone
(660) 851-0699
NPI assigned
Jan 7, 2010
Last updated
Feb 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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 089371 MO Primary

Addresses

Primary practice location

4400 S Limit Ave
Suite B
Sedalia, MO 65301-1179

Mailing address

4400 S Limit Ave
Suite B
Sedalia, MO 65301-1179

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
I20100525000994 MO Practitioner - Nurse Practitioner 3173652492 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
089371MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bothwell Regional Health Center Current Accepting new patients
Bothwell Regional Health Center CurrentSince Jan 17, 2022 Accepting new patients
Bothwell Regional Health Center CurrentSince Jan 17, 2022 Accepting new patients

Locations

3700 W 10th St
Ste 200
Sedalia, MO 65301
Phone (660) 827-1771

601 E 14th St
Sedalia, MO 65301
Phone (660) 826-8833

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.

NPI Registry JSON

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

{
    "created_epoch": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1902136369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 S LIMIT AVE",
            "address_2": "SUITE B",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653011179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 S LIMIT AVE",
            "address_2": "SUITE B",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653011179",
            "telephone_number": "660-851-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLARD",
        "first_name": "ROBIN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-07",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "089371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedalia, MO

Sources for this page

Verify at the official NPI Registry.