Individual provider Active NPI

Karen A Fenstermacher, NP

  • Nurse Practitioner
  • Neosho, MO
National Provider Identifier
1992730303
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
073207 Issued in MO
Practice address
2550 Lusk Dr
Neosho, MO 64850-8855
Phone
(417) 451-2060
Fax
(417) 451-6214
NPI assigned
Jul 12, 2006
Last updated
Mar 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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 073207 MO Primary

Addresses

Primary practice location

2550 Lusk Dr
Neosho, MO 64850-8855

Mailing address

2550 Lusk Dr
Neosho, MO 64850-8855
Phone (417) 451-2060

Other identifiers 1

IdentifierTypeStateIssuer
428635809MedicaidMO

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
I20071126000158 MO Practitioner - Nurse Practitioner 8224126412 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
073207MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Joplin CurrentSince Jan 1, 2015 Accepting new patients
Mercy Hospital Joplin CurrentSince Jan 1, 2015 Accepting new patients

Locations

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

2550 Lusk Dr
Neosho, MO 64850
Phone (417) 451-2060

Interoperability endpoints

  • Direct secure messaging: kfenstermacher299719@directb.mercy.net

Organizations & group practices 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1992730303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 LUSK DR",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648508855",
            "telephone_number": "417-451-2060",
            "fax_number": "417-451-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 LUSK DR",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648508855",
            "telephone_number": "417-451-2060",
            "fax_number": "417-451-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENSTERMACHER",
        "first_name": "KAREN",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "073207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428635809",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neosho, MO

Sources for this page

Verify at the official NPI Registry.