NPIMap

Individual provider Active NPI

Kelsi Brooke Yates, NP

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1366934069
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018024047 Issued in MO
Practice address
1965 S Fremont Ave Ste 230
Springfield, MO 65804-2258
Phone
(417) 820-7250
NPI assigned
May 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2010025709 MO
Family Nurse Practitioner 363LF0000X 2018024047 MO Primary

Addresses

Primary practice location

1965 S Fremont Ave Ste 230
Springfield, MO 65804-2258

Mailing address

1965 S Fremont Ave Ste 230
Springfield, MO 65804-2258
Phone (417) 820-7250

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
I20180713000373 MO Practitioner - Nurse Practitioner 8820344377 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1965 S Fremont Ave
370 MC Urology S Fremont
Springfield, MO 65804-2284
Phone (417) 820-0300

448 State Hwy 248
Suite 160
Branson, MO 65616-3725
Phone (417) 213-4696

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2010025709MOMDRegistered Nurse
2018024047MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Family CurrentSince Jul 19, 2018 Accepting new patients
Citizens Memorial Healthcare CurrentSince Dec 28, 2020 Accepting new patients
Mercy Hospital Springfield Current Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Nov 3, 2019 Accepting new patients
Citizens Memorial Healthcare CurrentSince Dec 28, 2020 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jul 19, 2018 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1155 W Parkview St
Ste 2C
Bolivar, MO 65613
Phone (417) 326-2550

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

448 State Highway 248
Ste 160
Branson, MO 65616
Phone (417) 213-4696

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1965 S Fremont Ave
Ste 370
Springfield, MO 65804
Phone (417) 820-0300

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1965 S Fremont Ave
Ste 230
Springfield, MO 65804
Phone (417) 820-3809

Organizations & group practices 7

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 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": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1366934069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 S FREMONT AVE STE 230",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042258",
            "telephone_number": "417-820-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 S FREMONT AVE STE 230",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042258",
            "telephone_number": "417-820-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "KELSI",
        "middle_name": "BROOKE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-30",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2010025709",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018024047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.