NPIMap

Individual provider Active NPI

Krista L Koinzan-Boyd, DO

  • Family Medicine Physician
  • Rogersville, MO
National Provider Identifier
1811950900
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
108854 Issued in MO
Practice address
101 S Main St
Rogersville, MO 65742-9357
Phone
(417) 753-9404
Fax
(417) 753-9137
NPI assigned
Apr 10, 2006
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 108854 MO Primary

Addresses

Primary practice location

101 S Main St
Rogersville, MO 65742-9357

Mailing address

101 S Main St
Rogersville, MO 65742-9357
Phone (417) 753-9404

Other practice location 1

543 W Hubble Dr
Marshfield, MO 65706-1532
Phone (417) 859-4878

Other identifiers 3

IdentifierTypeStateIssuer
243981107MedicaidMO
P00282287OtherRR MEDICARE
1811950900MedicaidMO

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address KBOYD@OCHHOSPITAL.HIN.US
Direct Messaging Address KBOYD@OCHHOSPITAL.HIN.US

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
I20051202000604 MO Practitioner - Family Practice 4880614908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sgoh Acquisition IncGroup PAC ID 5092616276, 95 clinicians
Cherry Health Center, LLCGroup PAC ID 1355317033, 97 clinicians

Practice addresses (Care Compare)

101 S Main St
Rogersville, MO 65742-9357
Phone (417) 753-9404

607 W Battlefield St
Springfield, MO 65807-4123
Phone (417) 869-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primrose Nephrology, Inc. Current Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

105 S Ridgecrest Ave
Nixa, MO 65714
Phone (417) 724-3100

105 S Ridgecrest Ave
#A
Nixa, MO 65714
Phone (417) 725-8250

1540 E Evergreen St
Springfield, MO 65803
Phone (417) 823-2900

Interoperability endpoints

  • Direct secure messaging: kboyd@ochhospital.hin.us

Organizations & group practices 4

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1811950900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657429357",
            "telephone_number": "417-753-9404",
            "fax_number": "417-753-9137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657429357",
            "telephone_number": "417-753-9404",
            "fax_number": "417-753-9137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "543 W Hubble Dr",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "MO",
            "postal_code": "657061532",
            "country_code": "US",
            "telephone_number": "417-859-4878",
            "fax_number": "417-859-0889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOINZAN-BOYD",
        "first_name": "KRISTA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "108854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243981107",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00282287",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811950900",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KBOYD@OCHHOSPITAL.HIN.US",
            "affiliation": "N",
            "address_1": "543 W Hubble Dr",
            "city": "Marshfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "657061532",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KBOYD@OCHHOSPITAL.HIN.US",
            "affiliation": "N",
            "address_1": "101 S Main St",
            "city": "Rogersville",
            "state": "MO",
            "country_code": "US",
            "postal_code": "657429357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rogersville, MO

Sources for this page

Verify at the official NPI Registry.