NPIMap

Individual provider Active NPI

Kathleen Quinn Willcox, D.O.

  • Family Medicine Physician
  • Mount Ayr, IA
National Provider Identifier
1205218112
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO-05187 Issued in IA
Practice address
Mount Ayr Medical Clinic
504 N. Cleveland St
Mount Ayr, IA 50854
Phone
(641) 464-3226
Fax
(641) 464-4476
NPI assigned
Jun 26, 2015
Last updated
Apr 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2015017596 MO
Family Medicine Physician 207Q00000X DO-05187 IA Primary

Addresses

Primary practice location

Mount Ayr Medical Clinic
504 N. Cleveland St
Mount Ayr, IA 50854

Mailing address

Mount Ayr Medical Clinic
504 N. Cleveland St
Mount Ayr, IA 50854
Phone (641) 464-3226

Other names 1

  • Miss Kathleen Quinn O'Neill Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20190123001962 IA Practitioner - Family Practice 6709158710 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ringgold County HospitalGroup PAC ID 7315849973, shared by 4 NPIs, 32 clinicians

Practice addresses (Care Compare)

504 N Cleveland St
Mount Ayr, IA 50854-2201
Phone (641) 464-3226

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Removal of nail tissue28
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-05187IAMDFamily Medicine Physician
2015017596MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ringgold County Hospital CurrentSince Dec 18, 2018 Accepting new patients
Ringgold County Hospital Current Accepting new patients
Ringgold County Hospital Current Accepting new patients
Ringgold County Hospital CurrentSince Dec 18, 2018 Accepting new patients

Locations

504 N Cleveland St
Mount Ayr, IA 50854
Phone (641) 464-3226

Interoperability endpoints

  • Direct secure messaging: kwillcox@mamc.gwaydirect.com

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ringgold County HospitalMount Ayr, IA, CCN 16Z373 Hospital W-2 Managing Employee
Operational/Managerial Control		 Dec 13, 2021
Dec 13, 2021
Ringgold County HospitalMount Ayr, IA, CCN 161373 Hospital W-2 Managing Employee
Operational/Managerial Control		 Dec 13, 2021
Dec 13, 2021
Clearview HomeMount Ayr, IA, CCN 165269 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2022
Sep 12, 2025
Mount Ayr Medical ClinicMount Ayr, IA, CCN 168570 Rural health clinic W-2 Managing Employee
Operational/Managerial Control		 Dec 13, 2021
Dec 13, 2021

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 9

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": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1205218112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MOUNT AYR MEDICAL CLINIC",
            "address_2": "504 N. CLEVELAND ST",
            "city": "MOUNT AYR",
            "state": "IA",
            "postal_code": "50854",
            "telephone_number": "641-464-3226",
            "fax_number": "641-464-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MOUNT AYR MEDICAL CLINIC",
            "address_2": "504 N. CLEVELAND ST",
            "city": "MOUNT AYR",
            "state": "IA",
            "postal_code": "50854",
            "telephone_number": "641-464-3226",
            "fax_number": "641-464-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLCOX",
        "first_name": "KATHLEEN",
        "middle_name": "QUINN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2015017596",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-05187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "O'NEILL",
            "middle_name": "QUINN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Ayr, IA

Sources for this page

Verify at the official NPI Registry.