Individual provider Active NPI

Kim D Colter, M.D.

  • Family Medicine Physician
  • Washington, MO
National Provider Identifier
1336112846
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R9434 Issued in MO
Practice address
901 Patients First Dr
Washington, MO 63090-4700
Phone
(636) 239-4100
Fax
(636) 390-4341
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R9434 MO Primary

Addresses

Primary practice location

901 Patients First Dr
Washington, MO 63090-4700

Mailing address

901 Patients First Dr
Washington, MO 63090-4700
Phone (636) 239-4100

Other identifiers 2

IdentifierTypeStateIssuer
201472313MedicaidMO
P01134554OtherMORAILROAD MEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100508000020 MO Practitioner - Family Practice 3375437049 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Washington University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, shared by 6 NPIs, 573 clinicians

Practice addresses (Care Compare)

1502 W Meyer Rd
Wentzville, MO 63385-3653
Phone (636) 698-6266

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R9434MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities Family Medicine CurrentSince Jun 26, 2016 Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
Mercy Hospitals East Communities Family Medicine CurrentSince Jun 26, 2016 Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients
Pacific Manor LLC Past Accepting new patients
Washington N & R, LLC Past Accepting new patients
Eldercare of Mid-Missouri Xiv Inc. Past Accepting new patients
New Haven Care Center, Inc Past Accepting new patients
Sunset Healthcare, LLC Past Accepting new patients

Locations

1015 Bowles Ave
Ste 1000
Fenton, MO 63026
Phone (636) 390-1400

9513 Highway 100
New Haven, MO 63068
Phone (573) 237-6100

1016 W Highway 28
Owensville, MO 65066
Phone (573) 437-6877

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500

851 E 5th St
Ste 200
Washington, MO 63090
Phone (636) 239-8585

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

1502 W Meyer Rd
Wentzville, MO 63385
Phone (636) 698-6200

Organizations & group practices 10

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 1

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1336112846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 PATIENTS FIRST DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904700",
            "telephone_number": "636-239-4100",
            "fax_number": "636-390-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 PATIENTS FIRST DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904700",
            "telephone_number": "636-239-4100",
            "fax_number": "636-390-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLTER",
        "first_name": "KIM",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R9434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201472313",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01134554",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

Verify at the official NPI Registry.