Individual provider Active NPI

Jean Marie Kelchen, MD

  • Pediatrics Physician
  • Springfield, MO
National Provider Identifier
1336430768
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2014006640 Issued in MO
Practice address
1000 E Primrose St
Springfield, MO 65807-5154
Phone
(417) 269-9812
Fax
(417) 269-2129
NPI assigned
Apr 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2014006640 MO Primary

Addresses

Primary practice location

1000 E Primrose St
Springfield, MO 65807-5154

Mailing address

PO Box 4046
Springfield, MO 65808-4046
Phone (417) 269-5712

Other names 1

  • Jean Marie Randall 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150416001616 MO Practitioner - Pediatric Medicine 7517198880 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Mar 23, 2015 Accepting new patients
Lester E Cox Medical Centers CurrentSince Nov 8, 2023 Accepting new patients
Lester E Cox Medical Centers CurrentSince Nov 11, 2017 Accepting new patients
Lester E Cox Medical Centers Pediatrics CurrentSince Mar 23, 2015 Accepting new patients
Lester E. Cox Medical Centers Current Accepting new patients
Lester E Cox Medical Centers Current Accepting new patients
Lester E Cox Medical Centers CurrentSince Nov 11, 2017 Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients

Locations

5100 N Towne Centre Dr
Ozark, MO 65721
Phone (417) 269-2215

2750 S Campbell Ave
Springfield, MO 65807
Phone (417) 269-2281

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

1000 E Primrose St
Ste 170
Springfield, MO 65807
Phone (417) 269-0930

Interoperability endpoints

  • Direct secure messaging: jean.kelchen@cernerdirect.coxhealth.com

Organizations & group practices 8

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": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1336430768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4046",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658084046",
            "telephone_number": "417-269-5712",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PRIMROSE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075154",
            "telephone_number": "417-269-9812",
            "fax_number": "417-269-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELCHEN",
        "first_name": "JEAN",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-19",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2014006640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "RANDALL",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.