Active NPI
Kimra Ross, MD
- Pediatrics Physician
- Joplin, MO
National Provider Identifier
1033149570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- R1P51
- 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, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149422 | Other | MO | ANTHEM |
| 100027400A | Medicaid | OK | |
| 203010707 | Medicaid | MO | |
| 100125890B | Medicaid | KS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| R1P51 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New 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 | Past | 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.
-
dba Health Essentials
- Oxygen Equipment & Supplies (DME)
- Neosho, MO
- NPI 1063477800
-
dba Freeman Health System
- General Acute Care Hospital
- Joplin, MO
- NPI 1265546048
-
dba Freeman Physician Group
- Multi-Specialty Clinic/Center
- Joplin, MO
- NPI 1679517023
Pediatrics
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.