NPIMap

Individual provider Active NPI

Kimberly Collins, ANP

  • Family Nurse Practitioner
  • Gravois Mills, MO
National Provider Identifier
1932203262
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
041208888 Issued in IL
Practice address
156 Missouri Blvd Ste B
Gravois Mills, MO 65037-5394
Phone
(573) 374-5263
Fax
(573) 374-4933
NPI assigned
Sep 8, 2006
Sex
Female
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.004230 IL
Family Nurse Practitioner 363LF0000X 041208888 IL Primary

Addresses

Primary practice location

156 Missouri Blvd Ste B
Gravois Mills, MO 65037-5394

Mailing address

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

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
I20170727003314 MO Practitioner - Nurse Practitioner 5294622833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
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)

1029 Nicholas Rd
Osage Beach, MO 65065-3008

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

1083 Ozark Care Dr
Osage Beach, MO 65065-3016
Phone (573) 348-1711

1191 Hwy KK
Suite 300
Osage Beach, MO 65065-3510
Phone (573) 302-4960

54 Hospital Dr
Osage Beach, MO 65065-3050

54 Hospital Dr
Osage Beach, MO 65065-3051

844 Passover Rd
Osage Beach, MO 65065-2834
Phone (573) 348-2225

872 College Blvd
Suite 8408
Osage Beach, MO 65065-8408
Phone (573) 302-0900

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041208888ILMDFamily Nurse Practitioner
209.004230ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Regional Health System CurrentSince Sep 1, 2017 Accepting new patients
Lake Regional Health System Current Accepting new patients
Lake Regional Health System CurrentSince Sep 1, 2017 Accepting new patients

Locations

226 E US Highway 54
Camdenton, MO 65020
Phone (573) 346-3700

304A E 4th St
Eldon, MO 65026
Phone (573) 392-5654

156 Missouri Blvd
Ste B
Gravois Mills, MO 65037
Phone (573) 374-5263

1870 Bagnell Dam Blvd
Lake Ozark, MO 65049
Phone (573) 365-2318

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

1057 Medical Park Dr
Osage Beach, MO 65065
Phone (573) 302-3100

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

Interoperability endpoints

  • Direct secure messaging: kimberlycollins@mhccaremail.com

Organizations & group practices 17

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 17

Hospital & facility affiliations 2

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": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1932203262",
    "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": "156 MISSOURI BLVD STE B",
            "city": "GRAVOIS MILLS",
            "state": "MO",
            "postal_code": "650375394",
            "telephone_number": "573-374-5263",
            "fax_number": "573-374-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "KIMBERLY",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.004230",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "041208888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gravois Mills, MO

Sources for this page

Verify at the official NPI Registry.