NPIMap

Individual provider Active NPI

Kristina Sue Kaufmann, DO

  • Family Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1952312282
Registry record updated May 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11012845 Issued in IN
Practice address
2434 Lake Ave
Fort Wayne, IN 46805-5406
Phone
(260) 423-2675
Fax
(260) 423-6621
NPI assigned
Aug 11, 2006
Last updated
May 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2011

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 11012845 IN Primary

Addresses

Primary practice location

2434 Lake Ave
Fort Wayne, IN 46805-5406

Mailing address

201 S. Ash
Buffalo, MO 65622
Phone (417) 345-6100

Other names 1

  • Kristina S Mueller Former name

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
I20081003000743 MO Practitioner - Family Practice 6608875646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1011 W Main
Buffalo, MO 65622-9288
Phone 4173452332101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11012845INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Health Department CurrentSince Mar 4, 2014 Accepting new patients
Citizens Memorial Healthcare CurrentSince Sep 1, 2008 Accepting new patients
Citizens Memorial Healthcare Family Medicine CurrentSince Sep 1, 2008 Accepting new patients
Citizens Memorial Hospital District Past Accepting new patients
Fort Wayne Medical Education Program Family Medicine PastSince Sep 1, 2024 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

1125 N Butterfield Rd
Bolivar, MO 65613
Phone (417) 326-7676

1300 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-7676

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

322 E Hospital Rd
El Dorado Springs, MO 64744
Phone (417) 876-2118

855 Arduser Dr
Osceola, MO 64776
Phone (417) 646-5075

Organizations & group practices 6

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 7

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305849600000",
    "number": "1952312282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S. ASH",
            "city": "BUFFALO",
            "state": "MO",
            "postal_code": "65622",
            "telephone_number": "417-345-6100",
            "fax_number": "417-345-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055406",
            "telephone_number": "260-423-2675",
            "fax_number": "260-423-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMANN",
        "first_name": "KRISTINA",
        "middle_name": "SUE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11012845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "MUELLER",
            "middle_name": "S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.