Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nancy D Lodge, MD

Individual provider Pediatrics Physician · NPI 1104973858

Nancy D Lodge, MD is a Pediatric Medicine in Fredericktown, Missouri. Graduated from Eastern Virginia Medical School in 1990, 36 years ago. Practices with Madison Medical Center Stockhoff Memorial Nursing Home, a 21-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
36
Trained at
Eastern Virginia Medical School
Licensed in
AZ
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

611 W Main St
Fredericktown, MO 63645-1111
Phone: (573) 783-3341
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 31111 (AZ)

Record details

NPI number1104973858
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 4, 2007
Last updated in NPPESJune 5, 2015
Mailing address611 W Main St, Fredericktown, MO 63645-1111

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolEASTERN VIRGINIA MEDICAL SCHOOL
Graduated 1990 (36 years in practice)
Group practice Madison Medical Center Stockhoff Memorial Nursing Home — 21 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount