DR. KYLIE KRISTEN POTTENGER (NPI# 1902219355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902219355 |
| Entity Type | Individual |
| Full Name | DR. KYLIE KRISTEN POTTENGER |
| Other Name | KYLIE WALKER |
| Credential | PSY.D. |
| Practice Address |
1423 N Jefferson Ave Springfield MO 65802-1917 |
| Mailing Address |
Po Box 4046 Springfield MO 65808-4046 |
| Practice Telephone | 4172697728 |
| Practice Fax Number | 4172697729 |
| Mailing Telephone | 4172695712 |
| Mailing Fax Number | 4172697567 |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2019-06-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
2013042520 | MO | Behavioral Health & Social Service Providers |
| Street Address |
1423 N JEFFERSON AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65802-1917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922004605 | Laird E. Jones | Psychiatry & Neurology | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2005-06-27 |
| 1396367264 | Brandon Allen Lane | Physical Therapist | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2020-05-13 |
| 1881215119 | Brenda Lea Stevens-ricci | Occupational Therapist | 1423 N Jefferson Ave, Springfield, MO 65802-1988 | 2020-04-28 |
| 1386263861 | Matthew A Murphy | Physical Therapist | 1423 N Jefferson Ave, Springfield, MO 65802-1988 | 2020-04-14 |
| 1790304277 | Phillip Wayne Goble | Physical Therapist | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2020-04-14 |
| 1568017150 | Sara Perry | Speech-Language Pathologist | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2019-08-09 |
| 1790330074 | Journey Mccarty | Pharmacist | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2019-08-05 |
| 1184180374 | Andrea James | Physician Assistant | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2019-02-13 |
| 1376036954 | Rebekah Elizabeth Pierce | Nurse Practitioner | 1423 N Jefferson Ave, Springfield, MO 65802-1988 | 2018-06-08 |
| 1477043263 | Christy Deann Laye | Nurse Practitioner | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2018-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454549 | Andrea Strauch | Counselor | 2024 W Chestnut Expressway Way, Springfield, MO 65802 | 2020-10-12 |
| 1962968867 | Chad Michael Linck | Specialist/Technologist | 2125 N Glenstone Ave, Springfield, MO 65802 | 2019-02-15 |
| 1790254647 | Meds To Live By | Pharmacist | 1134 N. Scarlett Way, Springfield, MO 65802 | 2018-11-21 |
| 1568945103 | Ficom | Non-Pharmacy Dispensing Site | 1308 North Glenstone Avenue, Springfield, MO 65802 | 2018-09-10 |
| 1982194775 | Karla Caballero | Marriage & Family Therapist | 8627 Montant Fort Way, 145, Sprinfield, MO 65802 | 2018-05-16 |
| 1780191809 | Tiffany Chawntay Coryell | Pharmacist | 1134 North Scarlett Way, Springfield, MO 65802 | 2018-01-10 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1407389596 | Medical Mile Imaging | Radiology | 3905 E Windsmore Dr, Springfield, MO 65802 | 2017-04-06 |
| 1346619103 | Jill A Knight | Occupational Therapist | 1601 E. Pythian, Green Valley State School, Springfield, MO 65802 | 2015-09-22 |
| 1447653258 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3720 E Sunshine St, Springfield, MO 65802 | 2014-10-07 |
| Find all providers in zip 65802 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
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| 1194359216 | Kathrin A Koehler | Psychologist | 4674 Hominy Ridge Rd, Springfield, OH 45502-8031 | 2020-02-27 |
| 1689126120 | Assessment Consultants, LLC | Psychologist | 2146 W Chesterfield Blvd Ste E202, Springfield, MO 65807-8650 | 2016-11-01 |
| 1003366436 | Caitriona Hayes | Psychologist | 8134 Old Keene Mill Road, Suite 101, Springfield, VA 22152 | 2016-10-10 |
| 1669929907 | Richart Lipe Demier | Psychologist | 5871 S Northern Ridge Rd, Springfield, MO 65810-1976 | 2016-09-03 |
| 1043660905 | Safe Harbor Christian Counseling of Northern Virginia LLC | Psychologist | 8304 Old Keene Mill Rd, Springfield, VA 22152-1640 | 2016-06-21 |
| 1659786432 | Kimberly Wilkins Psyd LLC | Psychologist | 1344 W Oakville Rd, Springfield, MO 65810-1696 | 2014-06-30 |
| 1548507817 | Bahn and Associates | Psychologist | 3000 Professional Dr Ste D, Bahn Consulting, Inc., Springfield, IL 62703-5931 | 2013-01-07 |
| 1396004990 | Cultivate Psychological Services LLC | Psychologist | 1439 S Rogers Ave, Springfield, MO 65804-1129 | 2012-05-16 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65802 |
Please comment or provide details below to improve the information on DR. KYLIE KRISTEN POTTENGER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.