Mrs Gwendolyn Broyles, PMHNP is a medicare enrolled "Clinical Nurse Specialist - Psychiatric/mental Health, Child & Family" in Osage Beach, Missouri. She graduated from nursing school in 2017 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Osage Beach Center For Behavioral Health, Llc and her current practice location is
840 Passover Rd, Osage Beach, Missouri. You can reach out to her office (for appointments etc.) via phone at
(573) 302-0319.
Mrs Gwendolyn Broyles is licensed to practice in Missouri (license number 2016032658) 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 1497282008.
Provider's Profile
| Full Name | Mrs Gwendolyn Broyles |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 7 Years |
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| Location | 840 Passover Rd, Osage Beach, 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:
- Mrs Gwendolyn Broyles graduated from nursing school in 2017
NPI Data:
- NPI Number: 1497282008
- Provider Enumeration Date: 05/12/2017
- Last Update Date: 05/12/2017
Medicare PECOS Information:
- PECOS PAC ID: 6800134222
- Enrollment ID: I20190211001497
Medical Identifiers
Medical identifiers for Mrs Gwendolyn Broyles such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1497282008 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 364SP0810X | Clinical Nurse Specialist - Psychiatric/mental Health, Child & Family | 2016032658 (Missouri) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Osage Beach Center For Behavioral Health, Llc | 2062649288 | 6 |
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 Gwendolyn Broyles allows following entities to bill medicare on her behalf.
| Entity Name | Osage Beach Center For Behavioral Health, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1790115939
PECOS PAC ID: 2062649288
Enrollment ID: O20140927000268 |
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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 Gwendolyn Broyles 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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Mrs Gwendolyn Broyles, PMHNP
840 Passover Rd,
Osage Beach, MO 65065-2834
Ph: (573) 302-0319 | Mrs Gwendolyn Broyles, PMHNP
840 Passover Rd,
Osage Beach, MO 65065-2834
Ph: (573) 302-0319 |
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