NPIMap

Individual provider Active NPI

Jacqueline F Yates, D.O.

  • Pediatrics Physician
  • Warrensburg, MO
National Provider Identifier
1518939230
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2004025543 Issued in MO
Practice address
510 Foster LN Ste 201
Warrensburg, MO 64093-3239
Phone
(602) 627-4156
Fax
(660) 262-7416
NPI assigned
Feb 6, 2006
Last updated
Dec 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2004025543 MO Primary

Addresses

Primary practice location

510 Foster LN Ste 201
Warrensburg, MO 64093-3239

Mailing address

821 Westwood Dr
Sedalia, MO 65301-2102
Phone (660) 826-4774

Other practice location 1

403 Burkarth Rd
Warrensburg, MO 64093-3101
Phone (660) 747-2500

Other names 1

  • Jacqueline Faye Johnson Former name

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
I20050413001135 MO Practitioner - Pediatric MedicinePractitioner - Sleep Medicine 6608813357 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Sleep Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Missouri Medical CenterGroup PAC ID 7416931506, 67 clinicians

Practice addresses (Care Compare)

510 Foster LN
Suite 201
Warrensburg, MO 64093-3239
Phone (660) 262-7415

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.21 of 100Reported as group
Quality
82.95
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Western Missouri Medical Center CurrentSince Nov 1, 2019 Accepting new patients
Western Missouri Medical Center CurrentSince Nov 1, 2019 Accepting new patients
Western Missouri Medical Center CurrentSince Nov 1, 2018 Accepting new patients
Western Missouri Medical Center CurrentSince Nov 1, 2018 Accepting new patients
Children's Mercy-Preferred Pediatrics Pediatrics Past Accepting new patients
Western Missouri Medical Center Past Accepting new patients

Locations

1200 W 22nd St
Higginsville, MO 64037
Phone (660) 262-7751

807 W 2nd St
Holden, MO 64040
Phone (660) 262-7309

600 E Allen St
Ste A
Knob Noster, MO 65336
Phone (660) 563-5555

403 Burkarth Rd
Warrensburg, MO 64093
Phone (660) 474-2500

510 Foster Ln
Ste 201
Warrensburg, MO 64093
Phone (660) 262-7415

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1518939230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 WESTWOOD DR",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012102",
            "telephone_number": "660-826-4774",
            "fax_number": "660-826-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 FOSTER LN STE 201",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640933239",
            "telephone_number": "602-627-4156",
            "fax_number": "660-262-7416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "403 Burkarth Rd",
            "address_purpose": "LOCATION",
            "city": "Warrensburg",
            "state": "MO",
            "postal_code": "640933101",
            "country_code": "US",
            "telephone_number": "660-747-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YATES",
        "first_name": "JACQUELINE",
        "middle_name": "F",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2004025543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "JOHNSON",
            "middle_name": "FAYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Warrensburg, MO

Sources for this page

Verify at the official NPI Registry.