NPIMap

Individual provider Active NPI

Kelly Lynn Mills, PA

  • Physician Assistant
  • West Plains, MO
National Provider Identifier
1366413262
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2007032284 Issued in MO
Practice address
805 N Kentucky Ave
West Plains, MO 65775-2022
Phone
(417) 256-2111
Fax
(417) 256-5214
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2007032284 MO Primary

Addresses

Primary practice location

805 N Kentucky Ave
West Plains, MO 65775-2022

Mailing address

805 N Kentucky Ave
West Plains, MO 65775-2022
Phone (417) 256-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20071115000621 MO Practitioner - Physician Assistant 6103739636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burton Creek Rural Clinic LLCGroup PAC ID 4587576244, 14 clinicians

Practice addresses (Care Compare)

805 N Kentucky Ave
West Plains, MO 65775-2045
Phone (417) 257-6100

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Rolla, MO, CCN 267098
  • Ozarks Healthcare Hospital, West Plains, MO, CCN 260078

Merit-based Incentive Payment System (MIPS)

Final score
98.15 of 100Reported as apm
Quality
88.15
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1089NEMDAddiction (Substance Use Disorder) Counselor
1099SCMDPharmacy Technician
2007032284MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients
Burton Creek Rural Clinic, LLC Past Accepting new patients
Alegent Health Memorial Hospital Schuyler Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kelly.mills.1@27794.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/27794/brand/1/csg/1/fhir/r4

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 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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1366413262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N KENTUCKY AVE",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752022",
            "telephone_number": "417-256-2111",
            "fax_number": "417-256-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N KENTUCKY AVE",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752022",
            "telephone_number": "417-256-2111",
            "fax_number": "417-256-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2007032284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

Verify at the official NPI Registry.