Individual provider Active NPI

Quentin Mabury, FNP

  • Nurse Practitioner
  • Saint Joseph, MO
National Provider Identifier
1952078792
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2021024181 Issued in MO
Practice address
901 Heartland Rd Ste 3800
Saint Joseph, MO 64506-6201
Phone
(816) 671-4800
NPI assigned
Aug 29, 2021
Last updated
Aug 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2021024181 MO Primary

Addresses

Primary practice location

901 Heartland Rd Ste 3800
Saint Joseph, MO 64506-6201

Mailing address

5301 Faraon St Ste 120
Saint Joseph, MO 64506-3512
Phone (816) 671-4800

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
I20220324001531 MO Practitioner - Nurse Practitioner 5193110328 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
Telehealth
Offers telehealth services
Group practices
Heartland Regional Medical CenterGroup PAC ID 6709772767, 394 clinicians

Practice addresses (Care Compare)

901 Heartland Rd
Suite 3800
Saint Joseph, MO 64506-6201
Phone (816) 671-4800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.76 of 100Reported as group
Quality
74.35
Promoting interoperability
100
Improvement activities
40
Cost
74.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021024181MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Regional Medical Center Current Accepting new patients
Heartland Regional Medical Center CurrentSince Mar 30, 2022 Accepting new patients
Heartland Regional Medical Center CurrentSince Mar 30, 2022 Accepting new patients

Locations

5202 Faraon St
Ste A
Saint Joseph, MO 64506
Phone (816) 271-1070

5301 Faraon St
Ste 120
Saint Joseph, MO 64506
Phone (816) 271-6406

901 Heartland Rd
Saint Joseph, MO 64506
Phone (816) 271-6000

901 Heartland Rd
Ste 2800
Saint Joseph, MO 64506
Phone (816) 271-1005

901 Heartland Rd
Ste 3800
Saint Joseph, MO 64506
Phone (816) 671-4800

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 4

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": "1630195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1952078792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 FARAON ST STE 120",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063512",
            "telephone_number": "816-671-4800",
            "fax_number": "816-233-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 HEARTLAND RD STE 3800",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645066201",
            "telephone_number": "816-671-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABURY",
        "first_name": "QUENTIN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-29",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2021024181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.