Individual provider Active NPI

Kyle Gillett, MD

  • Family Medicine Physician
  • Springfield, MO
National Provider Identifier
1942720065
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2017019816 Issued in MO
Practice address
1423 N Jefferson Ave # B100
Springfield, MO 65802-1917
Phone
(417) 269-8817
Fax
(417) 269-8744
NPI assigned
Jun 20, 2017
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
Family Medicine Physician 207Q00000X 2017019816 MO Primary

Addresses

Primary practice location

1423 N Jefferson Ave # B100
Springfield, MO 65802-1917

Mailing address

1423 N Jefferson Ave # B100
Springfield, MO 65802-1917
Phone (417) 269-8817

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190906000585 MO Practitioner - Family Practice 0547599201 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017019816MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
Lester E. Cox Medical Centers Family Medicine Current Accepting new patients
Lester E Cox Medical Centers CurrentSince Aug 1, 2019 Accepting new patients

Locations

1423 N Jefferson Ave
#B100
Springfield, MO 65802
Phone (417) 269-8817

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

Interoperability endpoints

  • Direct secure messaging: kyle.gillett@418618838286340.direct.elationemr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1942720065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 N JEFFERSON AVE # B100",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658021917",
            "telephone_number": "417-269-8817",
            "fax_number": "417-269-8744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 N JEFFERSON AVE # B100",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658021917",
            "telephone_number": "417-269-8817",
            "fax_number": "417-269-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETT",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2017019816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.