Individual provider Active NPI

Kristina R Grant, DO

  • Family Medicine Physician
  • Houston, MO
National Provider Identifier
1356922298
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2024021247 Issued in MO
Practice address
1337 S Sam Houston Blvd
Houston, MO 65483-2046
Phone
(417) 967-5435
Fax
(417) 967-5503
NPI assigned
Apr 20, 2021
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 2024021247 MO Primary

Addresses

Primary practice location

1337 S Sam Houston Blvd
Houston, MO 65483-2046

Mailing address

1337 S Sam Houston Blvd
Houston, MO 65483-2046
Phone (417) 967-5435

Other practice location 1

502 E Monroe St
Rapid City, SD 57701-1400
Phone (605) 755-4060

Other identifiers 2

IdentifierTypeStateIssuer
200142346MedicaidMO
26D0889777OtherMOCLIA

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
I20240723000967 MO Practitioner - Family Practice 2264835685 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas County Memorial HospitalGroup PAC ID 9436041696, 30 clinicians

Practice addresses (Care Compare)

1333 S Sam Houston Blvd
Houston, MO 65483-2046

1333 S Sam Houston Blvd a
TCMH Outpatient Clinic
Houston, MO 65483-2046
Phone (417) 967-1252

1335 S Sam Houston Blvd
Houston, MO 65483-2046

1337 S Sam Houston Blvd
Houston, MO 65483-2046
Phone (417) 967-5435

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
84.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024021247MOMDFamily Medicine Physician
0610SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas County Memorial Hospital CurrentSince Aug 1, 2024 Accepting new patients
Texas County Memorial Hospital Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Rolla Dermatology LLC CurrentSince Jan 10, 2026 Accepting new patients
Texas County Memorial Hospital Past Accepting new patients
Texas County Memorial Hospital Family Medicine Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

1333 S Sam Houston Blvd
Houston, MO 65483
Phone (417) 967-1252

1335 S Sam Houston Blvd
Houston, MO 65483
Phone (417) 967-5639

1337 S Sam Houston Blvd
Houston, MO 65483
Phone (417) 967-5435

1312 E State Highway 72
Rolla, MO 65401
Phone (573) 426-4112

Organizations & group practices 6

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 4

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": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1356922298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1337 S SAM HOUSTON BLVD",
            "city": "HOUSTON",
            "state": "MO",
            "postal_code": "654832046",
            "telephone_number": "417-967-5435",
            "fax_number": "417-967-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 S SAM HOUSTON BLVD",
            "city": "HOUSTON",
            "state": "MO",
            "postal_code": "654832046",
            "telephone_number": "417-967-5435",
            "fax_number": "417-967-5503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 E Monroe St",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "577011400",
            "country_code": "US",
            "telephone_number": "605-755-4060",
            "fax_number": "605-755-4012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "KRISTINA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2024021247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200142346",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "26D0889777",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, MO

Sources for this page

Verify at the official NPI Registry.