Active NPI
Christa Cheyenne Goodwin, DO
- Family Medicine Physician
- Smithville, MO
National Provider Identifier
1487159976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2020038020
- Practice address
- 1103 S US Highway 169
Smithville, MO 64089-9322 - Phone
- (816) 691-5340
- Fax
- (816) 346-7054
- NPI assigned
- Mar 27, 2018
- Last updated
- Nov 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Family Medicine Physician | 207Q00000X | 2018020725 | MO | |
| Family Medicine Physician | 207Q00000X | 2020038020 | MO | Primary |
Addresses
Primary practice location
1103 S US Highway 169
Smithville, MO 64089-9322
Mailing address
1103 S US Highway 169
Smithville, MO 64089-9322
Phone (816) 691-5340
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487159976 | Medicaid | MO |
Other names 1
- Christa Cheyenne McKahan
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1103 S Hwy 169
Suite C
Smithville, MO 64089-9322
Phone (816) 691-5340
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meritas Health Corporation | Current | Accepting new patients | |
| Meritas Health Corporation | Family Medicine | Current | Accepting new patients |
| Meritas Health Corporation | Family Medicine | Current | Accepting new patients |
| Meritas Health Corporation | Family Medicine | Past | Accepting new patients |
| Meritas Health Corporation | Family Medicine | Past | Accepting new patients |
Locations
2700 Clay Edwards Dr
Ste 240
North Kansas City, MO 64116
Phone (816) 455-0681
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Neurology Physician
- Kansas City, MO
- NPI 1669323291
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Skilled Nursing Unit
- Skilled Nursing Facility
- North Kansas City, MO
- NPI 1437103215
Hospital
-
dba NKC Health
- General Acute Care Hospital
- North Kansas City, MO
- NPI 1629062799
-
dba Saint Luke's Norland Hospital-Smithville
- General Acute Care Hospital
- Kansas City, MO
- NPI 1942241799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636416000000",
"number": "1487159976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1103 S US HIGHWAY 169",
"city": "SMITHVILLE",
"state": "MO",
"postal_code": "640899322",
"telephone_number": "816-691-5340",
"fax_number": "816-346-7054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1103 S US HIGHWAY 169",
"city": "SMITHVILLE",
"state": "MO",
"postal_code": "640899322",
"telephone_number": "816-691-5340",
"fax_number": "816-346-7054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "CHRISTA",
"middle_name": "CHEYENNE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-27",
"last_updated": "2021-11-09",
"certification_date": "2021-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "2018020725",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "2020038020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1487159976",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHRISTA",
"last_name": "MCKAHAN",
"middle_name": "CHEYENNE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Smithville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.