Individual provider Active NPI

Kimra Ross, MD

  • Pediatrics Physician
  • Joplin, MO
National Provider Identifier
1033149570
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R1P51 Issued in MO
Practice address
1030 McIntosh Cir
Ste 2
Joplin, MO 64804-3642
Phone
(417) 782-9393
Fax
(417) 782-4659
NPI assigned
Jul 3, 2006
Last updated
Mar 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R1P51 MO Primary

Addresses

Primary practice location

1030 McIntosh Cir
Ste 2
Joplin, MO 64804-3642

Mailing address

PO Box 3810
Joplin, MO 64803
Phone (417) 347-4662

Other practice location 1

3333 McIntosh Cir Ste 6
Joplin, MO 64804-3681
Phone (417) 347-2229

Other identifiers 4

IdentifierTypeStateIssuer
149422OtherMOANTHEM
100027400AMedicaidOK
203010707MedicaidMO
100125890BMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R1P51MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Freeman-Oak Hill Health System Past Accepting new patients
Freeman-Oak Hill Health System Past Accepting new patients
Freeman-Oak Hill Health System Pediatrics PastSince Oct 12, 2023 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1033149570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64803",
            "telephone_number": "417-347-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 MCINTOSH CIR",
            "address_2": "STE 2",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043642",
            "telephone_number": "417-782-9393",
            "fax_number": "417-782-4659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 McIntosh Cir Ste 6",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648043681",
            "country_code": "US",
            "telephone_number": "417-347-2229",
            "fax_number": "417-347-8465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KIMRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "R1P51",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "149422",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100027400A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203010707",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100125890B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.