Healthcare Provider Details

I. General information

NPI: 1295471811
Provider Name (Legal Business Name): ALPS HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2022
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S RIDGECREST AVE STE 3C
NIXA MO
65714-6206
US

IV. Provider business mailing address

PO BOX 397
NIXA MO
65714-0397
US

V. Phone/Fax

Practice location:
  • Phone: 417-210-7003
  • Fax: 417-210-7006
Mailing address:
  • Phone: 417-719-4510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE COOLEY
Title or Position: SUPERVISOR CREDENTIALING AND BILLIN
Credential:
Phone: 417-989-0140