Individual provider Active NPI

Kenzie Alexus Wolfe, PA

  • Physician Assistant
  • Branson, MO
National Provider Identifier
1003632019
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2025003004 Issued in MO
Practice address
525 Branson Landing Blvd
Branson, MO 65616-2052
Phone
(417) 335-7000
NPI assigned
Nov 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2025003004 MO Primary

Addresses

Primary practice location

525 Branson Landing Blvd
Branson, MO 65616-2052

Mailing address

PO Box 505673
Saint Louis, MO 63150-5673

Other practice location 1

1000 E Hwy 60
Monett, MO 65708-8258
Phone (417) 354-1269

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250226001908 MO Practitioner - Physician Assistant 8325568918 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizens Memorial Hospital DistrictGroup PAC ID 2769574433, 50 clinicians

Practice addresses (Care Compare)

1500 N Oakland Ave
Citizens Memorial Hospital
Bolivar, MO 65613-3011
Phone (417) 326-6000

Hospital & facility affiliations

  • Cox Medical Center Branson Hospital, Branson, MO, CCN 260094
  • Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195
  • Cox Monett Hospital Hospital, Monett, MO, CCN 261329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skaggs Community Hospital Association CurrentSince Mar 24, 2025 Accepting new patients
Skaggs Community Hospital Association CurrentSince Mar 24, 2025 Accepting new patients
Skaggs Community Hospital Association Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1003632019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505673",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 BRANSON LANDING BLVD",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656162052",
            "telephone_number": "417-335-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 E Hwy 60",
            "address_purpose": "LOCATION",
            "city": "Monett",
            "state": "MO",
            "postal_code": "657088258",
            "country_code": "US",
            "telephone_number": "417-354-1269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "KENZIE",
        "middle_name": "ALEXUS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2025003004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

Verify at the official NPI Registry.