Individual provider Active NPI

Annette Noel Mense, PA

  • Physician Assistant
  • Carthage, MO
National Provider Identifier
1992196778
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2015004694 Issued in MO
Practice address
3125 Dr Russell Smith Way
Carthage, MO 64836-7402
Phone
(417) 359-1849
Fax
(417) 237-7259
NPI assigned
Feb 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2015004694 MO Primary

Addresses

Primary practice location

3125 Dr Russell Smith Way
Carthage, MO 64836-7402

Mailing address

3125 Dr Russell Smith Way
Carthage, MO 64836-7402
Phone (417) 359-1849

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
I20150326000277 MO Practitioner - Physician Assistant 8628395936 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians

Practice addresses (Care Compare)

100 Mercy Way
Joplin, MO 64804-4524

2620 Cunningham Ave
Joplin, MO 64804-1542
Phone (417) 624-2621

Hospital & facility affiliations

  • Mercy Hospital Carthage Hospital, Carthage, MO, CCN 261338
  • Mercy Hospital Joplin Hospital, Joplin, MO, CCN 260001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2015004694MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Jul 25, 2020 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jul 25, 2020 Accepting new patients

Locations

94 Main St
Cassville, MO 65625
Phone (417) 782-7722

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1423872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1992196778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 DR RUSSELL SMITH WAY",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648367402",
            "telephone_number": "417-359-1849",
            "fax_number": "417-237-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 DR RUSSELL SMITH WAY",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648367402",
            "telephone_number": "417-359-1849",
            "fax_number": "417-237-7259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENSE",
        "first_name": "ANNETTE",
        "middle_name": "NOEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-14",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2015004694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, MO

Sources for this page

Verify at the official NPI Registry.