NPIMap

Individual provider Active NPI

Kelly Marti, PA

  • Medical Physician Assistant
  • Branson, MO
National Provider Identifier
1619095270
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2014023983 Issued in MO
Practice address
1150 State Highway 248 Ste 200
Branson, MO 65616-4186
Phone
(417) 336-4112
Fax
(417) 335-4684
NPI assigned
Mar 26, 2007
Last updated
Feb 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2014023983 MO Primary

Addresses

Primary practice location

1150 State Highway 248 Ste 200
Branson, MO 65616-4186

Mailing address

PO Box 802843
Kansas City, MO 64180-2843
Phone (417) 730-6430

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
I20140822000271 MO Practitioner - Physician Assistant 2365408002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1150 State Hwy 248
Suite 200
Branson, MO 65616-4186
Phone (417) 336-4112

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.41 of 100Reported as group
Quality
76.32
Promoting interoperability
100
Improvement activities
40
Cost
81.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skaggs Community Hospital Association Current Accepting new patients
Skaggs Community Hospital Association CurrentSince Jul 28, 2014 Accepting new patients
Skaggs Community Hospital Association CurrentSince Jul 28, 2014 Accepting new patients
Granite City Clinic Corp Past Accepting new patients
Anderson Medical Group, LLC PastSince Jun 1, 2016 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Skaggs Community Hospital Association Past Accepting new patients

Locations

1150 State Highway 248
Ste 200
Branson, MO 65616
Phone (417) 336-4112

525 Branson Landing Blvd
Ste 508
Branson, MO 65616
Phone (417) 335-7540

Interoperability endpoints

  • Direct secure messaging: kelly.marti@cernerdirect.coxhealth.com

Organizations & group practices 7

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 4

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1619095270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802843",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641802843",
            "telephone_number": "417-730-6430",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 STATE HIGHWAY 248 STE 200",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656164186",
            "telephone_number": "417-336-4112",
            "fax_number": "417-335-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTI",
        "first_name": "KELLY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2014023983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

Verify at the official NPI Registry.