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Mary Jane Patterson

Physician β€’ Qulin, MO

Active NPI 1265566020 Individual Practitioner Female Practitioner
Practice location in NPPES

12948 Highway 53
Qulin, MO 639618260

Call 5733284026 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

12948 Highway 53

Qulin, MO 639618260

Telephone 5733284026
Fax 5733284883

NPI first issued

2007

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Community/Behavioral Health Primary Specialty

NUCC Taxonomy Code: 251S00000X

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Residential Treatment Facility, Intellectual and/or Developmental Disabilities

NUCC Taxonomy Code: 320600000X

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

Respite Care - Respite Care, Intellectual and/or Developmental Disabilities, Child

NUCC Taxonomy Code: 385HR2060X

A facility or distinct part of a facility that provides short term, residential care to children diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Missouri Board of Registration for the Healing Arts.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 11, 2025

Community/Behavioral Health

βœ…
NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 09, 2007

Registered at 12948 HIGHWAY 53, QULIN, MO 639618260 (Tel: 5733284026)

πŸ“
Business Mailing Address (Initial Record) July 09, 2007

Registered at 12948 HIGHWAY 53, QULIN, MO 639618260 (Tel: 5733284026)

πŸ‘€
Provider Name / Credentials (Initial Record) July 09, 2007

Recorded as MARY PATTERSON

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Residential Treatment Facility, Intellectual and/or Developmental Disabilities

🟒
Initial NPI Registration & Enumeration March 15, 2007

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1265566020
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 15, 2007
Last Update: September 11, 2025
Sole Proprietor: Yes

Mailing Address

12948 Highway 53

Qulin, MO 639618260

Phone: 5733284026

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.