Individual provider Active NPI

Krystal S Colvin Jones, FNP

  • Family Nurse Practitioner
  • Willow Springs, MO
National Provider Identifier
1679703623
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2001018537 Issued in MO
Practice address
2642 State Route 76
Willow Springs, MO 65793-8254
Phone
(417) 469-5124
Fax
(417) 469-1165
NPI assigned
Jul 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2001018537 MO Primary

Addresses

Primary practice location

2642 State Route 76
Willow Springs, MO 65793-8254

Mailing address

2642 St. RT. 76
Willow Springs, MO 65793-0309
Phone (417) 469-5124

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110128000127 MO Practitioner - Nurse Practitioner 3476732058 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2001018537MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Citizens Memorial Healthcare CurrentSince Nov 1, 2024 Accepting new patients
Citizens Memorial Healthcare CurrentSince Nov 1, 2024 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1679703623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2642 ST. RT. 76",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657930309",
            "telephone_number": "417-469-5124",
            "fax_number": "417-469-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2642 STATE ROUTE 76",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657938254",
            "telephone_number": "417-469-5124",
            "fax_number": "417-469-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLVIN JONES",
        "first_name": "KRYSTAL",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2001018537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Springs, MO

Sources for this page

Verify at the official NPI Registry.