Active NPI
Kody Blake Finstad, M.D.
- Pediatrics Physician
- Nixa, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2007015054
- Practice address
- 940 W Mount Vernon St Ste 220
Nixa, MO 65714 - Phone
- (417) 724-5437
- Fax
- (417) 724-5433
- NPI assigned
- Sep 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2007015054 | MO | Primary |
Addresses
Primary practice location
940 W Mount Vernon St Ste 220
Nixa, MO 65714
Mailing address
940 W Mount Vernon St Ste 220
Nixa, MO 65714-9613
Phone (417) 724-5437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932396777 | Medicaid | MO |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100813001029 | MO | Practitioner - Pediatric Medicine | 5890829717 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007015054 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Hospital Springfield | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
940 W Mount Vernon St
Ste 220
Nixa, MO 65714
Phone (417) 724-5437
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379
620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
Interoperability endpoints
- kfinstad158541@directb.mercy.net
- kfinstad168574@directc.mercy.net
Organizations & group practices 5
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.
-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
MO
-
- Rural Health Clinic/Center
- Summersville, MO
- NPI 1053444000
-
- General Acute Care Hospital
- Springfield, MO
- NPI 1578504056
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530489600000",
"number": "1932396777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 W MOUNT VERNON ST STE 220",
"city": "NIXA",
"state": "MO",
"postal_code": "657149613",
"telephone_number": "417-724-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 W MOUNT VERNON ST STE 220",
"city": "NIXA",
"state": "MO",
"postal_code": "65714",
"telephone_number": "417-724-5437",
"fax_number": "417-724-5433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FINSTAD",
"first_name": "KODY",
"middle_name": "BLAKE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-25",
"last_updated": "2018-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2007015054",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1932396777",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Nixa, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.