Ms Connie Marie Dochterman, APRN,BC is a medicare enrolled "Nurse Practitioner - Family" in Canton, Missouri. She graduated from nursing school in 1985 and has 39 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Hannibal Regional Healthcare System Inc and her current practice location is
1802 Elm St, Canton-lagrange Family Practice, Canton, Missouri. You can reach out to her office (for appointments etc.) via phone at
(573) 288-5360.
Ms Connie Marie Dochterman is licensed to practice in Missouri (license number 100511) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1578578316.
Provider's Profile
| Full Name | Ms Connie Marie Dochterman |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 39 Years |
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| Location | 1802 Elm St, Canton, Missouri |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Ms Connie Marie Dochterman graduated from nursing school in 1985
NPI Data:
- NPI Number: 1578578316
- Provider Enumeration Date: 07/30/2006
- Last Update Date: 04/19/2012
Medicare PECOS Information:
- PECOS PAC ID: 4284759499
- Enrollment ID: I20100910001123
Medical Identifiers
Medical identifiers for Ms Connie Marie Dochterman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1578578316 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 100511 (Missouri) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Hannibal Regional Healthcare System Inc | 1254236300 | 205 |
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. Ms Connie Marie Dochterman allows following entities to bill medicare on her behalf.
| Entity Name | Hannibal Regional Healthcare System Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134311392
PECOS PAC ID: 1254236300
Enrollment ID: O20071004000422 |
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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. Ms Connie Marie Dochterman 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 |
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Ms Connie Marie Dochterman, APRN,BC
Po Box 309, Canton-lagrange Family Practice,
Canton, MO 63435-0309
Ph: (573) 288-5360 | Ms Connie Marie Dochterman, APRN,BC
1802 Elm St, Canton-lagrange Family Practice,
Canton, MO 63435-1694
Ph: (573) 288-5360 |
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