NPIMap

Individual provider Active NPI

Kathy G. Beckner, PA-C

  • Physician Assistant
  • Lebanon, MO
National Provider Identifier
1831209089
Registry record updated Mar 24, 2022
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Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2000174330 Issued in MO
Practice address
128 E Commercial St
Lebanon, MO 65536-3257
Phone
(573) 302-3990
Fax
(573) 302-2753
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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 2000174330 MO Primary

Addresses

Primary practice location

128 E Commercial St
Lebanon, MO 65536-3257

Mailing address

54 Hospital Dr
Osage Beach, MO 65065-3050
Phone (573) 348-8399

Other practice location 1

1075 Nichols Rd
Osage Beach, MO 65065-3093
Phone (573) 302-3990

Other names 1

  • Kathy G. Williams Former name

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
I20070213000481 MO Practitioner - Physician Assistant 6507868007 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Regional Health SystemGroup PAC ID 9133026776, 132 clinicians

Practice addresses (Care Compare)

1075 Nichols Rd
Osage Beach, MO 65065-3093
Phone (573) 302-3990

54 Hospital Dr
Osage Beach, MO 65065-3050

755 Cowan Dr
Lebanon, MO 65536-4629
Phone (417) 532-2805

Hospital & facility affiliations

  • Lake Regional Health System Hospital, Osage Beach, MO, CCN 260186
  • Mercy Hospital Lebanon Hospital, Lebanon, MO, CCN 260059

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Oct 3, 2006 Accepting new patients
Lake Regional Medical Management, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Oct 1, 2019 Accepting new patients
Mercy Clinic-Springfield Communities CurrentSince Oct 3, 2006 Accepting new patients
Lake Regional Health System CurrentSince Apr 1, 2025 Accepting new patients
Wellpointe Family Medical Past Accepting new patients
Lake Regional Health System Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

331 Hospital Dr
Ste A
Lebanon, MO 65536
Phone (417) 532-8856

128 E Commercial St
Lebanon, MO 65536
Phone (573) 302-3990

755 Cowan Dr
Lebanon, MO 65536
Phone (417) 532-2805

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Interoperability endpoints

  • Direct secure messaging: kathybeckner@mhccaremail.com
  • Direct secure messaging: kbeckner2369@directb.mercy.net

Organizations & group practices 23

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.

View all 23

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1831209089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DR",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050",
            "telephone_number": "573-348-8399",
            "fax_number": "573-348-8309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 E COMMERCIAL ST",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655363257",
            "telephone_number": "573-302-3990",
            "fax_number": "573-302-2753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1075 Nichols Rd",
            "address_purpose": "LOCATION",
            "city": "Osage Beach",
            "state": "MO",
            "postal_code": "650653093",
            "country_code": "US",
            "telephone_number": "573-302-3990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECKNER",
        "first_name": "KATHY",
        "middle_name": "G.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2000174330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "WILLIAMS",
            "middle_name": "G.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lebanon, MO

Sources for this page

Verify at the official NPI Registry.