NPIMap

Individual provider Active NPI

Pamela Lynn Ralls, M.D.

  • Family Medicine Physician
  • Carrollton, MO
National Provider Identifier
1023252541
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2008018043 Issued in MO
Practice address
1502 N.Jefferson Street
CCMH Medical Plaza
Carrollton, MO 64633
Phone
(660) 542-1695
Fax
(660) 542-9880
NPI assigned
Apr 28, 2009
Last updated
Dec 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2008018043 MO Primary

Addresses

Primary practice location

1502 N.Jefferson Street
CCMH Medical Plaza
Carrollton, MO 64633

Mailing address

1502 N Jefferson St
CCMH Medical Plaza Attn: Jean Steele
Carrollton, MO 64633
Phone (660) 542-1695

Other practice location 1

221 Elm St
Hale, MO 64643-7113
Phone (660) 565-2602

Other names 1

  • Dr. Pamela Lynn Hackstedt Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CCMHHIMDept@ccmhospital.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110105000151 MO Practitioner - Family PracticePractitioner - Emergency Medicine 6204025380 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carroll County Memorial HospitalGroup PAC ID 2860485638, 64 clinicians
Jefferson Medical GroupGroup PAC ID 6800894379, 10 clinicians

Practice addresses (Care Compare)

1502 N Jefferson St
Carrollton, MO 64633-1948
Phone (660) 542-1695

221 Elm St
Hale, MO 64643-7161
Phone (660) 565-2602

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
69.76 of 100Reported as group
Quality
46.12
Promoting interoperability
100
Improvement activities
40
Cost
53.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2008018043MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Medical Group Family Medicine CurrentSince Jan 1, 2017 Accepting new patients
Jefferson Medical Group Family Medicine CurrentSince Jan 1, 2017 Accepting new patients
Carroll County Memorial Hospital CurrentSince Jan 1, 2017 Accepting new patients
Jefferson Medical Group Past Accepting new patients
Saint Lukes Hospital of Trenton PastSince Jan 28, 2011 Accepting new patients
United Investors LP Past Accepting new patients

Locations

1502 N Jefferson St
Carrollton, MO 64633
Phone (660) 542-1695

221 Elm St
Hale, MO 64643
Phone (660) 542-1695

Interoperability endpoints

  • Direct secure messaging: ccmhhimdept@ccmhospital.cernerdirect.com
  • Direct secure messaging: pamralls@ccmhospital.cernerdirect.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1023252541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 N JEFFERSON ST",
            "address_2": "CCMH MEDICAL PLAZA ATTN: JEAN STEELE",
            "city": "CARROLLTON",
            "state": "MO",
            "postal_code": "64633",
            "telephone_number": "660-542-1695",
            "fax_number": "660-542-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 N.JEFFERSON STREET",
            "address_2": "CCMH MEDICAL PLAZA",
            "city": "CARROLLTON",
            "state": "MO",
            "postal_code": "64633",
            "telephone_number": "660-542-1695",
            "fax_number": "660-542-9880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 Elm St",
            "address_purpose": "LOCATION",
            "city": "Hale",
            "state": "MO",
            "postal_code": "646437113",
            "country_code": "US",
            "telephone_number": "660-565-2602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RALLS",
        "first_name": "PAMELA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2008018043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CCMHHIMDept@ccmhospital.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1502 N.Jefferson Street",
            "address_2": "CCMH Medical Plaza",
            "city": "Carrollton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "64633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "HACKSTEDT",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carrollton, MO

Sources for this page

Verify at the official NPI Registry.