Vivian Dudley, is a medicare enrolled "Nurse Practitioner" in Bourbon, Missouri. She graduated from nursing school in 2000 and has 24 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Mercy Clinic East Communities and her current practice location is
125 N Old Hwy 66, Bourbon, Missouri. You can reach out to her office (for appointments etc.) via phone at
(573) 679-2006.
Vivian Dudley is licensed to practice in Missouri (license number 142760) 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 1013018654.
Provider's Profile
| Full Name | Vivian Dudley |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 24 Years |
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| Location | 125 N Old Hwy 66, Bourbon, 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:
- Vivian Dudley graduated from nursing school in 2000
NPI Data:
- NPI Number: 1013018654
- Provider Enumeration Date: 09/26/2006
- Last Update Date: 08/25/2014
Medicare PECOS Information:
- PECOS PAC ID: 8628158391
- Enrollment ID: I20080108000085
Medical Identifiers
Medical identifiers for Vivian Dudley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013018654 | NPI | - | NPPES |
| 1013018654 | Medicaid | MO | |
| 425076205 | Medicaid | MO | |
| P01134574 | Other | MO | RAILROAD MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 142760 (Missouri) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Mercy Clinic East Communities | 7214827922 | 499 |
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. Vivian Dudley allows following entities to bill medicare on her behalf.
| Entity Name | Mercy Clinic East Communities |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073739041
PECOS PAC ID: 7214827922
Enrollment ID: O20070521000058 |
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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. Vivian Dudley 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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Vivian Dudley,
125 N Old Hwy 66,
Bourbon, MO 65441
Ph: (573) 679-2006 | Vivian Dudley,
125 N Old Hwy 66,
Bourbon, MO 65441
Ph: (573) 679-2006 |
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