Renae Jenelle Richardson, is a medicare enrolled "Nurse Practitioner" in Kimberling City, Missouri. She graduated from nursing school in 2021 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Fordland Clinic, Inc. and her current practice location is
11863 State Highway 13, Kimberling City, Missouri. You can reach out to her office (for appointments etc.) via phone at
(417) 739-1995.
Renae Jenelle Richardson is licensed to practice in Missouri (license number 2021019189) 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 1659045847.
Provider's Profile
| Full Name | Renae Jenelle Richardson |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 4 Years |
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| Location | 11863 State Highway 13, Kimberling City, 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:
- Renae Jenelle Richardson graduated from nursing school in 2021
NPI Data:
- NPI Number: 1659045847
- Provider Enumeration Date: 08/03/2021
- Last Update Date: 11/20/2022
Medicare PECOS Information:
- PECOS PAC ID: 4486050036
- Enrollment ID: I20210907001174
Medical Identifiers
Medical identifiers for Renae Jenelle Richardson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1659045847 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 2021019189 (Missouri) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Fordland Clinic, Inc. | 5597794552 | 8 |
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. Renae Jenelle Richardson allows following entities to bill medicare on her behalf.
| Entity Name | Fordland Clinic, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1881607612
PECOS PAC ID: 5597794552
Enrollment ID: O20050913000367 |
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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. Renae Jenelle Richardson 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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Renae Jenelle Richardson,
4332 E Ambrose Dr,
Springfield, MO 65802-2425
Ph: (417) 251-2922 | Renae Jenelle Richardson,
11863 State Highway 13,
Kimberling City, MO 65686-8362
Ph: (417) 739-1995 |
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