Kristina Klaverkamp, MSPA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1176339 Issued in MO

Practice address

2810 Frank Scott Pkwy W Ste 716
Belleville, IL 62223-5007

Phone

(618) 355-0880

NPI assigned

Jun 13, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1592006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1033734272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 FRANK SCOTT PKWY W STE 716",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235007",
            "telephone_number": "618-355-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 FRANK SCOTT PKWY W STE 716",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235007",
            "telephone_number": "618-355-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAVERKAMP",
        "first_name": "KRISTINA",
        "name_prefix": "Miss",
        "credential": "MSPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-13",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "1176339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Lynn Kipping, M.S., CCC-SLP
• Meaghan Kipping, PT, DPT
• Brenda Kirk
• Megan Nicole Kirk, LCPC
• Deborah Kirsch, SLP
• Emily Catherine Klein, FNP
• Matthew Robert Kleinlein, BA
• Chelsie Klieber, DPT
• Robert Norton Klopper, PT
• Kurt Kloss, M.D.

• Physician Assistant in Belleville, IL
• Providers in Belleville, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.