NPIMap

Individual provider Active NPI

Krista M Clark, DO

  • Family Medicine Physician
  • Chillicothe, MO
National Provider Identifier
1962727743
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2013021426 Issued in MO
Practice address
2791 N Washington St
Hedrick Family Care
Chillicothe, MO 64601-2902
Phone
(660) 646-2682
Fax
(660) 214-8611
NPI assigned
Apr 5, 2010
Last updated
Jun 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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 2013021426 MO Primary

Addresses

Primary practice location

2791 N Washington St
Hedrick Family Care
Chillicothe, MO 64601-2902

Mailing address

2791 N Washington St
Hedrick Family Care
Chillicothe, MO 64601-2902
Phone (660) 646-2682

Other names 1

  • Krista M Blackmore 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
I20131024000653 MO Practitioner - Family Practice 9830324052 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Hospital of ChillicotheGroup PAC ID 0143130393, shared by 4 NPIs, 25 clinicians

Practice addresses (Care Compare)

2791 N Washington St
Chillicothe, MO 64601-2902
Phone (816) 646-1480

2799 N Washington St
Chillicothe, MO 64601-2902
Phone (660) 646-1480

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.69 of 100Reported as group
Quality
88.35
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Lukes Hospital of Chillicothe CurrentSince Sep 1, 2013 Accepting new patients
Saint Lukes Hospital of Trenton CurrentSince Aug 15, 2018 Accepting new patients
Saint Luke's Hospital of Trenton CurrentSince Jul 1, 2025 Accepting new patients
Saint Lukes Hospital of Chillicothe CurrentSince Sep 1, 2013 Accepting new patients
Saint Lukes Hospital of Chillicothe CurrentSince Jul 1, 2025 Accepting new patients
Saint Luke's Hospital of Trenton Family Medicine CurrentSince Aug 15, 2018 Accepting new patients
Saint Lukes Hospital of Chillicothe Past Accepting new patients

Locations

2791 N Washington St
Chillicothe, MO 64601
Phone (816) 646-1480

2799 N Washington St
Chillicothe, MO 64601
Phone (660) 214-8300

400 N Fullerton St
Princeton, MO 64673
Phone (660) 748-4040

189 Iowa Blvd
Trenton, MO 64683
Phone (660) 358-5750

191 Iowa Blvd
Trenton, MO 64683
Phone (660) 358-5700

Interoperability endpoints

  • FHIR API: https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4
  • Direct secure messaging: kclark5272@direct.saint-lukes.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hedrick Medical CenterChillicothe, MO, CCN 261321 Hospital Corporate Director Jan 1, 2023
Hedrick Medical CenterChillicothe, MO, CCN 26Z321 Hospital Corporate Director Jan 1, 2018
Hedrick Medical CenterChillicothe, MO, CCN 268539 Rural health clinic Corporate Director Jan 1, 2018

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 8

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": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1962727743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2791 N WASHINGTON ST",
            "address_2": "HEDRICK FAMILY CARE",
            "city": "CHILLICOTHE",
            "state": "MO",
            "postal_code": "646012902",
            "telephone_number": "660-646-2682",
            "fax_number": "660-214-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2791 N WASHINGTON ST",
            "address_2": "HEDRICK FAMILY CARE",
            "city": "CHILLICOTHE",
            "state": "MO",
            "postal_code": "646012902",
            "telephone_number": "660-646-2682",
            "fax_number": "660-214-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KRISTA",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2013021426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "BLACKMORE",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chillicothe, MO

Sources for this page

Verify at the official NPI Registry.