Individual provider Active NPI

McKinzie Jo Kizer, FNP

  • Family Nurse Practitioner
  • Bridgeton, MO
National Provider Identifier
1053290171
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2025022894 Issued in MO
Practice address
3550 McKelvey Rd
Bridgeton, MO 63044-2527
Phone
(314) 741-0911
Fax
(314) 218-9622
NPI assigned
Sep 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2025022894 MO Primary

Addresses

Primary practice location

3550 McKelvey Rd
Bridgeton, MO 63044-2527

Mailing address

3550 McKelvey Rd
Bridgeton, MO 63044-2527
Phone (314) 741-0911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20251023003294 IL Practitioner - Nurse Practitioner 8729576483 Reassigns benefits to 1 organization
I20251106000457 MO Practitioner - Nurse Practitioner 8729576483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Louis Heart and Vascular PCGroup PAC ID 7719880129, 22 clinicians

Practice addresses (Care Compare)

2120 Madison Ave
Suite 101
Granite City, IL 62040-4746
Phone (618) 876-8214

3550 McKelvey Rd
Bridgeton, MO 63044-2527
Phone (314) 741-0911

Hospital & facility affiliations

  • Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180
  • Gateway Regional Medical Center Hospital, Granite City, IL, CCN 140125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2025022894MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Louis Heart & Vascular, P.C. CurrentSince Sep 1, 2025 Accepting new patients

Locations

2120 Madison Ave
Ste 101
Granite City, IL 62040
Phone (618) 798-3000

3550 McKelvey Rd
Bridgeton, MO 63044
Phone 31474109114048

1551 Wall St
Ste 410
Saint Charles, MO 63303
Phone (314) 838-5702

2325 Dougherty Ferry Rd
Ste 203
Saint Louis, MO 63122
Phone (314) 480-6445

3009 N Ballas Rd
Ste 100B
Saint Louis, MO 63131
Phone (314) 270-1796

11155 Dunn Rd
Ste 304E
Saint Louis, MO 63136
Phone 3147410911 ext. 4012

105 Creekside Office Dr
Wentzville, MO 63385
Phone (636) 639-6262

Interoperability endpoints

  • Direct secure messaging: mckinzie.kizer.p5@direct.ahgcardiology.nextgenshare.com

Organizations & group practices 1

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 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": "1756771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1053290171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 MCKELVEY RD",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442527",
            "telephone_number": "314-741-0911",
            "fax_number": "314-218-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 MCKELVEY RD",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442527",
            "telephone_number": "314-741-0911",
            "fax_number": "314-218-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZER",
        "first_name": "MCKINZIE",
        "middle_name": "JO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-02",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025022894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

Verify at the official NPI Registry.