Kurt Russell Bravata, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

2013030074 Issued in MO

Practice address

201 S Ash St
Buffalo, MO 65622-8674

Phone

(417) 345-6100

Fax

(417) 345-6866

NPI assigned

Jun 30, 2010

Last updated

Dec 29, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Citizens Memorial HealthcareGroup PAC ID 4183528169, 144 clinicians

Ozarks Resource GroupGroup PAC ID 6002068723, 12 clinicians

Cherry Health Center, LLCGroup PAC ID 1355317033, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Citizens Memorial Home Health Home health agency, Bolivar, MO, CCN 267196
• Citizens Memorial Hospice Hospice, Bolivar, MO, CCN 261508
• Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195
• Cox Medical Centers Hospital, Springfield, MO, CCN 260040

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Citizens Memorial Healthcare

  • Surgery Physician
  • Bolivar, MO
  • NPI 1568566131
  Medicare reassignment Care Compare group NPD
• Ozarks Resource Group

  dba Ozarks Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Hermitage, MO
  • NPI 1639421050
  Medicare reassignment Care Compare group NPD
• Cherry Health Center, LLC

  • Physical Therapist
  • Springfield, MO
  • NPI 1770628620
  Care Compare group
• Citizens Memorial Healthcare

  dba CMH Willard Medical Center

  • Rural Health Clinic/Center
  • Willard, MO
  • NPI 1568127397
  NPD
• Ozarks Resource Group

  dba Ozarks Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Urbana, MO
  • NPI 1659942027
  NPD
• Citizens Memorial Health Care Foundation

  dba Colonial Springs Healthcare Center

  • Skilled Nursing Facility
  • Buffalo, MO
  • NPI 1346229481
  NPD (past)
• Citizens Memorial Healthcare

  dba Dade County Family Medical Center

  • Rural Health Clinic/Center
  • Greenfield, MO
  • NPI 1699989350
  NPD (past)
• Citizens Memorial Healthcare

  dba Pleasant Hope Family Medical Center

  • Rural Health Clinic/Center
  • Pleasant Hope, MO
  • NPI 1740494541
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Citizens Memorial Health Care Foundation

  dba Citizens Memorial Hospice

  • Community Based Hospice Care Agency
  • Bolivar, MO
  • NPI 1124157169
  Care Compare affiliation
• Citizens Memorial Health Care Foundation

  dba Citizens Memorial Home Health

  • Home Health Agency
  • Bolivar, MO
  • NPI 1376672238
  Care Compare affiliation
• Citizens Memorial Hospital District

  dba Citizens Memorial Hospital

  • General Acute Care Hospital
  • Bolivar, MO
  • NPI 1003981549
  Care Compare affiliation
• Lester E Cox Medical Centers

  dba Cox Medical Centers

  • General Acute Care Hospital
  • Springfield, MO
  • NPI 1093740128
  Care Compare affiliation
• Lester E Cox Medical Centers

  dba CoxHealth

  • Land Ambulance
  • Springfield, MO
  • NPI 1114044823

  Hospital

  Care Compare affiliation
• Lester E. Cox Medical Centers

  dba Cox Air Care

  • Air Ambulance
  • Springfield, MO
  • NPI 1578680286

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1790096170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-328-6501",
            "fax_number": "417-328-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S ASH ST",
            "city": "BUFFALO",
            "state": "MO",
            "postal_code": "656228674",
            "telephone_number": "417-345-6100",
            "fax_number": "417-345-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVATA",
        "first_name": "KURT",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2013030074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD",
            "identifier": "P01259379",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Blake
• Leanne Boggs, M.S., LPC
• Bolivar Family Counseling Center LLC
• William Dyer Booth, DDS
• Brandi F Bowden, MS, LPC
• Bristol Care,Inc.
• Buffalo Prairie Dental
• Buffalo Prairie Nursing and Rehab LLC (Buffalo Prairie Center for Rehab and Healthcare)
• Buffalo Prairie Opco, LLC (Buffalo Prairie Center for Rehab and Healthcare)
• Buffalo Prairie Operations Management LLC

• General Practice Physician in Buffalo, MO
• Providers in Buffalo, MO by specialty
• General Practice Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.

Verify at the official NPI Registry.