Kylie Kristen Pottenger, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2013042520 Issued in MO

Practice address

5083 E Hackberry St
Springfield, MO 65809-8901

Phone

(417) 429-4580

NPI assigned

Jun 3, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kylie Walker Former name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Lester E Cox Medical Centers

  • Psychiatry Physician
  • Springfield, MO
  • NPI 1073905915
  Medicare reassignment NPD
• A New Day Psychology LLC

  • Adult Mental Health Clinic/Center
  • Springfield, MO
  • NPI 1588413900
  NPD Authorized official
• Lester E Cox Medical Centers

  • Geriatric Medicine (Internal Medicine) Physician
  • Springfield, MO
  • NPI 1356068605
  NPD
• Lester E Cox Medical Centers

  • Psychologist
  • Springfield, MO
  • NPI 1770139735

  Clinical

  NPD

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1902219355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4046",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658084046",
            "telephone_number": "417-718-3805",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5083 E HACKBERRY ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658098901",
            "telephone_number": "417-429-4580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1423 N Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658021917",
            "country_code": "US",
            "telephone_number": "417-269-7728",
            "fax_number": "417-269-7729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTENGER",
        "first_name": "KYLIE",
        "middle_name": "KRISTEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2013042520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLIE",
            "last_name": "WALKER",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Lynn Porter, LMSW
• Celia Rae Posada, M.D.
• Andrew A. Post, DO
• Zachary Poteet, HIS
• Egor Potekin, M.D.
• Chad Jeremy Potter, MD
• Ethan Potter, LCSW
• Lisa Marie Potthoff, NP-C
• Sujan Poudel, M.D.
• Powell Becker & Scott DDS PC

• Clinical Psychologist in Springfield, MO
• Providers in Springfield, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.