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NANCY D LODGE MD
NPI 1104973858
Pediatrics in Fredericktown, MO

Active since January 04, 2007PECOS Enrolled
611 W MAIN ST, FREDERICKTOWN, MO 63645(573) 783-3341 Get Directions Write a Review

NPPES record last updated: June 5, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Nancy D Lodge Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NANCY D LODGE MD (NPI 1104973858) is an individual pediatrics provider in Fredericktown, Missouri, licensed in Arizona (31111) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104973858
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameNANCY D LODGECredential: MD
Location Address611 W MAIN STFredericktown, MO 63645-1111
Mailing Address611 W Main StFredericktown, MO 63645-1111 · (573) 783-3341
Phone(573) 783-3341
Sole ProprietorNo
Enumeration DateJanuary 4, 2007
Last NPPES UpdateJune 5, 2015
✔ NPI 1104973858 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in AZ · 31111
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
611 W MAIN ST, Fredericktown, MO 63645
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Other Names 1

Former Name (1)Nancy Barnett Md

Other Identifiers 4

Other1Z9363AZ · Healthnet
Medicaid164351AZ
Other4575331AZ · Aetna Us Healthcare
OtherAZ0729800AZ · Blue Cross Blue Sheild

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nancy D Lodge Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Nancy Lodge reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Madison Medical Center
Same address
Emergency Medicine
611 W MAIN ST
Fredericktown, MO 63645
  • Reassigned Medicare billing, Missouri enrollment
  • Medicare enrollment name: Madison Medical Center Stockhoff Memorial Nursing Home
  • Also billed through NPI 1720163025 (Missouri)
  • 34 clinicians in this Medicare group
NPI 1669514436 (573) 783-3341

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63645 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHARLES M WALBAUM CRNA
Nurse Anesthetist, Certified Registered
611 W MAIN ST
FREDERICKTOWN, MO 63645
Madison County (573) 783-3341
MELINDA JO FISCHER RN, BC, FNP
Nurse Practitioner (Family)
611 W MAIN ST
FREDERICKTOWN, MO 63645
Madison County (573) 783-4111
MICHELE RUBEL M.P.T.
Mechanotherapist
611 W MAIN ST
FREDERICKTOWN, MO 63645
Madison County (573) 783-1092
CRAIG J. MILLHAM P.T.
Mechanotherapist
611 W MAIN ST
FREDERICKTOWN, MO 63645
Madison County (573) 783-1092
MADISON MEDICAL CENTER
Durable Medical Equipment & Medical Supplies
611 W MAIN ST
FREDERICKTOWN, MO 63645
Madison County (573) 783-3341
ALANNA GUESS NP-C
Nurse Practitioner (Family)
611 W MAIN ST
FREDERICKTOWN, MO 63645
Madison County (573) 783-3341
LORNA DIANNE STOOKEY M.D.
Family Medicine
611 W MAIN ST
FREDERICKTOWN, MO 63645
Madison County (573) 783-4111
PATRICK O'HARA
Family Medicine
611 W MAIN ST
FREDERICKTOWN, MO 63645
Madison County (573) 783-3341

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nancy Lodge's NPI number?

The NPI number for Nancy Lodge is 1104973858. It was assigned to this individual provider in the NPPES registry on January 4, 2007. The provider is also known as Nancy Barnett MD.

Where is Nancy Lodge located?

Nancy Lodge practices at 611 W Main St, Fredericktown, MO 63645. The listed phone number is (573) 783-3341.

What is Nancy Lodge's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Nancy Lodge enrolled in Medicare?

Yes. Nancy Lodge is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nancy Lodge's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nancy Lodge reassigns Medicare benefits to Madison Medical Center (Fredericktown, MO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nancy Lodge's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nancy Lodge accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 3 other insurers list Nancy Lodge as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nancy Lodge was last updated on June 5, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.