Individual provider Active NPI

Stephanie Jo Neal, FNP

  • Family Nurse Practitioner
  • Cape Girardeau, MO
National Provider Identifier
1922517911
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017033172 Issued in MO
Practice address
211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
Phone
(573) 331-3000
Fax
(573) 331-5079
NPI assigned
Sep 22, 2017
Last updated
Mar 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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 2017033172 MO Primary

Addresses

Primary practice location

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049

Mailing address

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
Phone (573) 331-3000

Other names 1

  • Stephanie Jo Richards 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
I20171109002961 MO Practitioner - Nurse Practitioner 2264798008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heartland Weight Loss Clinic, LLCGroup PAC ID 7113339607, 5 clinicians

Practice addresses (Care Compare)

64 Doctors Park
Cape Girardeau, MO 63703-4928
Phone (573) 987-5355

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Weight Loss Clinic, LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

3095 Lexington Ave
Ste 200
Cpe Girardeau, MO 63701
Phone (573) 339-0004

64 Doctors Park
Cpe Girardeau, MO 63703
Phone (573) 334-5265

Organizations & group practices 1

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": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1922517911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SAINT FRANCIS DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035049",
            "telephone_number": "573-331-3000",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SAINT FRANCIS DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035049",
            "telephone_number": "573-331-3000",
            "fax_number": "573-331-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "STEPHANIE",
        "middle_name": "JO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-22",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017033172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "RICHARDS",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.