Individual provider Active NPI

Kalynn Woods

  • Physician Assistant
  • Mountain Grove, MO
National Provider Identifier
1922634732
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2020007079 Issued in MO
Practice address
1604 C. North Main Street
Mountain Grove, MO 65711
Phone
(417) 926-1713
NPI assigned
Mar 13, 2020
Last updated
Mar 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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 2020007079 MO Primary

Addresses

Primary practice location

1604 C. North Main Street
Mountain Grove, MO 65711

Mailing address

PO Box 1359
Ava, MO 65608-1359

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200329000541 MO Practitioner - Physician Assistant 3870922719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

504 W Broadway Ave
Missouri Ozarks Community Health
Ava, MO 65608-1359
Phone (417) 683-5739

804 N Hwy 5
Missouri Ozarks Community Health
Mansfield, MO 65704-7301
Phone (417) 924-8809

87 Elm St
Missouri Ozarks Community Health
Gainesville, MO 65655-7131
Phone (417) 679-2775

PO Box
Suite 1359
Ava, MO 65608-1359

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas County Public Health Services Group, Inc. CurrentSince Mar 9, 2020 Accepting new patients
Douglas County Public Health Services Group, Inc. CurrentSince Mar 9, 2020 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1604 N Main St
#C
Mountain Grove, MO 65711
Phone (417) 926-1713

Organizations & group practices 3

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 3

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": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1922634732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1359",
            "city": "AVA",
            "state": "MO",
            "postal_code": "656081359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 C. NORTH MAIN STREET",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "65711",
            "telephone_number": "417-926-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "KALYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-13",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2020007079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Grove, MO

Sources for this page

Verify at the official NPI Registry.