Kaylee Villasenor, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2023007276 Issued in MO

Practice address

440 E Tampa St
Springfield, MO 65806-1131

Phone

(417) 831-0150

NPI assigned

Feb 24, 2023

Last updated

Oct 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advocates for a Healthy Community IncGroup PAC ID 5395653562, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kaylee.gagnon.p1@direct.jordanvalley.nextgenshare.com
• Direct secure messaging: kvillasenor694709@direct.ochin.org

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.

• Advocates for a Healthy Community, Inc

  dba Jordan Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Springfield, MO
  • NPI 1558303057
  Medicare reassignment Care Compare group NPD
• Advocates for a Healthy Community Inc

  dba Jordan Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Buffalo, MO
  • NPI 1750179610
  NPD
• Advocates for a Healthy Community, Inc.

  dba Jordan Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Springfield, MO
  • NPI 1861590861
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1417656828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 E TAMPA ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061131",
            "telephone_number": "417-831-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E TAMPA ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061131",
            "telephone_number": "417-831-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLASENOR",
        "first_name": "KAYLEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-24",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2023007276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220120973",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robbin Vigil, OTR/L
• Jaunine Marie Viles, R.D., L.D.
• Village Chiropractic LLC
• Amanda M Villarreal, LCSW
• Gregoria Villaruel-Kirk, FNP
• None Vimal Ravi, MD
• Vincel Dental LLC (Ozark's Preferred Dental Group)
• George William Vincel, DMD
• Hillary Laurel Vincel, DMD
• Jeremy C. Vincent, M.A., PLPC

• Physician Assistant in Springfield, MO
• Providers in Springfield, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.