Individual provider Active NPI

Kyla Inman

  • Family Nurse Practitioner
  • Bolivar, MO
National Provider Identifier
1043760341
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016029743 Issued in MO
Practice address
1240 N Butterfield Rd
Bolivar, MO 65613-3016
Phone
(417) 326-6021
NPI assigned
Oct 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016029743 MO Primary

Addresses

Primary practice location

1240 N Butterfield Rd
Bolivar, MO 65613-3016

Mailing address

1500 N Oakland Ave
Bolivar, MO 65613-3011
Phone (417) 326-6021

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address citizensmemorialhospital@mhccaremail.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170103001145 MO Practitioner - Nurse Practitioner 8022399179 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Citizens Memorial Healthcare CurrentSince Nov 28, 2016 Accepting new patients
Citizens Memorial Healthcare CurrentSince Nov 28, 2016 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1240 N Butterfield Rd
Bolivar, MO 65613
Phone (417) 326-6021

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1043760341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-326-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 N BUTTERFIELD RD",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133016",
            "telephone_number": "417-326-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INMAN",
        "first_name": "KYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-11",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016029743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "citizensmemorialhospital@mhccaremail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1240 N Butterfield Rd",
            "city": "Bolivar",
            "state": "MO",
            "country_code": "US",
            "postal_code": "656133016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

Verify at the official NPI Registry.