NPIMap

Individual provider Active NPI

Kendell C. Clarkston, M.D.

  • Internal Medicine Physician
  • West Plains, MO
National Provider Identifier
1922116284
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
110746 Issued in MO
Practice address
1100 N Kentucky Ave
West Plains, MO 65775-2029
Phone
(417) 257-5800
Fax
(417) 257-5999
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 110746 MO Primary

Addresses

Primary practice location

1100 N Kentucky Ave
West Plains, MO 65775-2029

Mailing address

PO Box 1100
West Plains, MO 65775-1100
Phone (417) 257-5800

Other identifiers 4

IdentifierTypeStateIssuer
208922419MedicaidMO
208633001MedicaidAR
128195OtherBLUE CROSS MO
1922116284MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051028000258 MO Practitioner - Internal MedicinePractitioner - Pediatric Medicine 1850318999 Reassigns benefits to 2 organizations
I20250115001810 KS Practitioner - Hospitalist 1850318999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone (913) 317-7000

4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-3100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as group
Quality
78.58
Promoting interoperability
99
Improvement activities
40
Cost
77.82

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center CurrentSince Apr 17, 2015 Accepting new patients
Ozarks Medical Center CurrentSince Apr 17, 2015 Accepting new patients
Saint Luke's Physician Group Inc Internal Medicine CurrentSince Jan 13, 2025 Accepting new patients
Lester E. Cox Medical Centers Past Accepting new patients
Golden Valley Memorial Hospital District Past Accepting new patients
Willow Health Care Inc Past Accepting new patients
University Health Physicians Internal Medicine Past Accepting new patients
Willow Health Care Inc Past Accepting new patients
St Lukes Hospital of Kansas City Past Accepting new patients

Locations

421 S Maple St
Garnett, KS 66032
Phone (785) 204-7105

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

12300 Metcalf Ave
Shawnee Mission, KS 66213
Phone (913) 317-7000

2799 N Washington St
Chillicothe, MO 64601
Phone (660) 214-8300

4401 Wornall Rd
Kansas City, MO 64111
Phone (816) 932-2107

901 E 104th St
Kansas City, MO 64131
Phone (816) 502-7117

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

1000 E Primrose St
Ste 360
Springfield, MO 65807
Phone (417) 269-4037

1100 N Kentucky Ave
West Plains, MO 65775
Phone (417) 257-5959

816 E Main St
Willow Springs, MO 65793
Phone (417) 269-2490

Interoperability endpoints

  • FHIR API: https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4
  • Direct secure messaging: kclarkston96517@direct.saint-lukes.org
  • Direct secure messaging: dr.clarkston@mhccaremail.com

Organizations & group practices 9

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 5

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1922116284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1100",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657751100",
            "telephone_number": "417-257-5800",
            "fax_number": "417-269-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N KENTUCKY AVE",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752029",
            "telephone_number": "417-257-5800",
            "fax_number": "417-257-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKSTON",
        "first_name": "KENDELL",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "110746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208922419",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208633001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MO",
            "identifier": "128195",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922116284",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Plains, MO

Sources for this page

Verify at the official NPI Registry.