Individual provider Active NPI

Kyle Christopher Fink, D.O.

  • Emergency Medicine Physician
  • Springfield, MO
National Provider Identifier
1457790230
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2017014183 Issued in MO
Practice address
3801 S National Ave
Springfield, MO 65807-5209
Phone
(417) 269-6583
Fax
(417) 269-6573
NPI assigned
Jun 14, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101020725 MI
Emergency Medicine Physician 207P00000X 2017014183 MO Primary

Addresses

Primary practice location

3801 S National Ave
Springfield, MO 65807-5209

Mailing address

PO Box 9007
Springfield, MO 65808-9007
Phone (417) 269-6583

Other identifiers 2

IdentifierTypeStateIssuer
1457790230MedicaidMO
200044527MedicaidMO

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
I20170817003685 MO Practitioner - Emergency Medicine 1355648841 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.52 of 100Reported as group
Quality
61.64
Promoting interoperability
100
Improvement activities
40
Cost
76.77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017014183MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E. Cox Medical Centers Current Accepting new patients
Lester E Cox Medical Centers Emergency Medicine CurrentSince Jul 18, 2017 Accepting new patients
Lester E Cox Medical Centers CurrentSince Mar 1, 2018 Accepting new patients
Lester E Cox Medical Centers CurrentSince Jul 18, 2017 Accepting new patients

Locations

1001 E Primrose St
Springfield, MO 65807
Phone (417) 875-3434

3801 S National Ave
Fl 5
Springfield, MO 65807

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

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.

NPI Registry JSON

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1457790230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658089007",
            "telephone_number": "417-269-6583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075209",
            "telephone_number": "417-269-6583",
            "fax_number": "417-269-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINK",
        "first_name": "KYLE",
        "middle_name": "CHRISTOPHER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-14",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101020725",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2017014183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457790230",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200044527",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.