Individual provider Active NPI

Jessica Rene Yeley, MSN,APRN,FNP-BC

  • Family Nurse Practitioner
  • Poplar Bluff, MO
National Provider Identifier
1912595547
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2021001528 Issued in MO
Practice address
2002 Kanell Blvd
Poplar Bluff, MO 63901-4011
Phone
(573) 727-9130
Fax
(573) 727-9128
NPI assigned
Jan 8, 2021
Last updated
May 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2021001528 MO Primary
Registered Nurse 163W00000X 2016003492 MO

Addresses

Primary practice location

2002 Kanell Blvd
Poplar Bluff, MO 63901-4011

Mailing address

2060 Highway HH
Poplar Bluff, MO 63901-5368
Phone (573) 727-9130

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
I20211022002337 MO Practitioner - Nurse Practitioner 9436547494 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2002 Kanell Blvd
Suite 106
Poplar Bluff, MO 63901-4045
Phone (573) 778-0020

2025 W Business US Hwy 60
Dexter, MO 63841-2879
Phone (573) 614-4600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
70.1 of 100Reported as group
Quality
41.46
Improvement activities
40
Cost
87.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016003492MOMDRegistered Nurse
2021001528MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Abdul Naushad MD PC CurrentSince Nov 1, 2021 Accepting new patients
Pemiscot County Memorial Hospital CurrentSince Nov 1, 2021 Accepting new patients
Southeast Health Center of Stoddard County, LLC CurrentSince Jan 3, 2022 Accepting new patients
Southeast Health Center of Stoddard County LLC Nurse Practitioner CurrentSince Jan 3, 2022 Accepting new patients
Pemiscot County Memorial Hospital CurrentSince Nov 1, 2021 Accepting new patients
Southeast Health Center of Stoddard County, LLC Current Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

35 Doctors Park
Ste B
Cape Girardeau, MO 63703
Phone (573) 335-4422

1200 N One Mile Rd
Dexter, MO 63841
Phone (573) 614-1900

907 E Reed St
Hayti, MO 63851
Phone (573) 359-3230

946 E Reed St
Hayti, MO 63851
Phone (573) 359-3408

2002 Kanell Blvd
Poplar Bluff, MO 63901
Phone (573) 727-9130

2002 Kanell Blvd
Ste 101
Poplar Bluff, MO 63901
Phone (573) 614-1900

2865 James Blvd
Poplar Bluff, MO 63901
Phone (573) 776-1100

Organizations & group practices 7

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 2

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": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1912595547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 HIGHWAY HH",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015368",
            "telephone_number": "573-727-9130",
            "fax_number": "573-727-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014011",
            "telephone_number": "573-727-9130",
            "fax_number": "573-727-9128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELEY",
        "first_name": "JESSICA",
        "middle_name": "RENE",
        "credential": "MSN,APRN,FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-08",
        "last_updated": "2022-05-17",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021001528",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2016003492",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.