Individual provider Active NPI

Keila Betzaira Young, DNP, FNP-C

  • Nurse Practitioner
  • Joplin, MO
National Provider Identifier
1104470087
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2019039974 Issued in MO
Practice address
3401 McIntosh Cir Ste 100
Joplin, MO 64804-3651
Phone
(417) 347-7200
NPI assigned
Jul 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2019039974 MO Primary

Addresses

Primary practice location

3401 McIntosh Cir Ste 100
Joplin, MO 64804-3651

Mailing address

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

Other names 1

  • Keila Betzaira Guzman Former name

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
I20200312001585 MO Practitioner - Nurse Practitioner 2668800228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Kansas City, School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeman-Oak Hill Health SystemGroup PAC ID 8325942253, 385 clinicians

Practice addresses (Care Compare)

1102 W 32 St
Joplin, MO 64804-3503
Phone (417) 347-4570

Hospital & facility affiliations

  • Freeman Health System - Freeman West Hospital, Joplin, MO, CCN 260137

Merit-based Incentive Payment System (MIPS)

Final score
81.37 of 100Reported as group
Quality
60.15
Promoting interoperability
100
Improvement activities
40
Cost
77.74

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Freeman-Oak Hill Health System CurrentSince Mar 1, 2020 Accepting new patients

Locations

510 Park St
Anderson, MO 64831
Phone (417) 845-0545

3401 McIntosh Cir
Ste 100
Joplin, MO 64804
Phone (417) 347-7200

1102 W 32nd St
Joplin, MO 64804
Phone (417) 347-1078

1905 W 32nd St
Ste 403
Joplin, MO 64804
Phone (417) 347-7200

307 W 11th St
Lamar, MO 64759
Phone (417) 682-3300

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1104470087",
    "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": "648033810",
            "telephone_number": "417-347-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 MCINTOSH CIR STE 100",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043651",
            "telephone_number": "417-347-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KEILA",
        "middle_name": "BETZAIRA",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2019039974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEILA",
            "last_name": "GUZMAN",
            "middle_name": "BETZAIRA",
            "credential": "DNP, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.