NPIMap

Individual provider Active NPI

Kimberly A Schisler, D.O.

  • Family Medicine Physician
  • Poplar Bluff, MO
National Provider Identifier
1386681328
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
113469 Issued in MO
Practice address
2210 Barron Rd
Poplar Bluff, MO 63901-1908
Phone
(573) 785-1333
Fax
(573) 785-1488
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2011

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 113469 MO Primary

Addresses

Primary practice location

2210 Barron Rd
Poplar Bluff, MO 63901-1908

Mailing address

2210 Barron Rd
Poplar Bluff, MO 63901-1908
Phone (573) 785-1333

Other identifiers 1

IdentifierTypeStateIssuer
244707907MedicaidMO

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
I20041027000003 MO Practitioner - Family Practice 4385605971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2210 Barron Rd
Suite 113
Poplar Bluff, MO 63901-1908

2210 Barron Rd
Suite 113
Poplar Bluff, MO 63901-1922
Phone (573) 785-1333

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
113469MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kimberly a Schisler D O P C Family Medicine CurrentSince Jul 1, 1999 Accepting new patients
Poplar Bluff Regional Medical Center LLC Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients
Helia Healthcare of Poplar Bluff, LLC Past Accepting new patients
State of Missouri Past Accepting new patients

Locations

2210 Barron Rd
Poplar Bluff, MO 63901
Phone (573) 686-4133

2210 Barron Rd
Ste 113
Poplar Bluff, MO 63901
Phone (573) 686-4133

Organizations & group practices 5

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1386681328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-785-1333",
            "fax_number": "573-785-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-785-1333",
            "fax_number": "573-785-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHISLER",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "113469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "244707907",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.