Mrs Brandi Nichole Tabor, APRN is a medicare enrolled "Family Medicine" in Fredericktown, Missouri. Her current practice location is
735 W Main St, Fredericktown, Missouri. You can reach out to her office (for appointments etc.) via phone at
(573) 783-8875.
Mrs Brandi Nichole Tabor is licensed to practice in Missouri (license number 2019011374) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063075752.
Provider's Profile
Full Name | Mrs Brandi Nichole Tabor |
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Gender | Female |
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Speciality | Family Medicine |
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Location | 735 W Main St, Fredericktown, Missouri |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1063075752
- Provider Enumeration Date: 04/17/2019
- Last Update Date: 10/05/2022
Medicare PECOS Information:
- PECOS PAC ID: 2668712613
- Enrollment ID: I20190919000391
Medical Identifiers
Medical identifiers for Mrs Brandi Nichole Tabor such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1063075752 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363L00000X | Nurse Practitioner | 2019011374 (Missouri) | Secondary |
207Q00000X | Family Medicine | 2019011374 (Missouri) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Brandi Nichole Tabor allows following entities to bill medicare on her behalf.
Entity Name | Steven D Crawford |
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Entity Type | Practitioner - Family Practice |
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Entity Identifiers | NPI Number: 1548266737 PECOS PAC ID: 9537127048 Enrollment ID: I20050927000450 |
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Entity Name | Community Health Care Associates Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1629286976 PECOS PAC ID: 8123016078 Enrollment ID: O20040713001144 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Brandi Nichole Tabor is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Brandi Nichole Tabor, APRN 733 W Main St Ste B, Fredericktown, MO 63645-1143 Ph: (573) 783-8875 | Mrs Brandi Nichole Tabor, APRN 735 W Main St, Fredericktown, MO 63645-1113 Ph: (573) 783-8875 |
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