NPIMap

Individual provider Active NPI

Kathy J. Rupert, PA

  • Physician Assistant
  • Springfield, MO
National Provider Identifier
1790082352
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2011001655 Issued in MO
Practice address
3801 S National Ave Ste 1122
Springfield, MO 65807-6090
Phone
(417) 269-7728
Fax
(417) 269-7729
NPI assigned
Feb 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2011001655 MO Primary

Addresses

Primary practice location

3801 S National Ave Ste 1122
Springfield, MO 65807-6090

Mailing address

PO Box 7411626
Chicago, IL 60674-5626

Other practice location 1

1660 W Garton Rd
Ozark, MO 65721
Phone (417) 269-3000

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
I20110331000467 MO Practitioner - Physician Assistant 7911180740 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cole Physician Services LLCGroup PAC ID 0648420810, 23 clinicians
Lester E Cox Medical CentersGroup PAC ID 5799787784, 240 clinicians

Practice addresses (Care Compare)

2505 Mission Dr
Jefferson City, MO 65109-9508
Phone (573) 681-3000

3801 S National Ave
Springfield, MO 65807-5210
Phone (417) 269-7820

3801 S National Ave
Springfield, MO 65807-6090
Phone (417) 269-7728

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.78 of 100Reported as group
Quality
74.39
Promoting interoperability
100
Improvement activities
40
Cost
78.21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Skaggs Community Hospital Association CurrentSince Mar 19, 2024 Accepting new patients
Lester E Cox Medical Centers CurrentSince Feb 21, 2011 Accepting new patients
Lester E Cox Medical Centers CurrentSince Feb 21, 2011 Accepting new patients
Lester E. Cox Medical Centers Past Accepting new patients

Locations

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

3801 S National Ave
Ste 1122
Springfield, MO 65807

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 and National Provider Directory roles.

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": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1790082352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7411626",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606745626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S NATIONAL AVE STE 1122",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658076090",
            "telephone_number": "417-269-7728",
            "fax_number": "417-269-7729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1660 W GARTON RD",
            "address_purpose": "LOCATION",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "65721",
            "country_code": "US",
            "telephone_number": "417-269-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUPERT",
        "first_name": "KATHY",
        "middle_name": "J.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2011001655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.