Kialy Ann Mudd, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2020019127 Issued in MO

Practice address

4280 Mid America LN Ste 30
Saint Louis, MO 63129-1202

Phone

(314) 782-2600

NPI assigned

Nov 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: kmudd527369@directc.mercy.net

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.

• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  Care Compare affiliation
• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1063015329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 SUMMER TOP LN",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630263946",
            "telephone_number": "314-809-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 MID AMERICA LN STE 30",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291202",
            "telephone_number": "314-782-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDD",
        "first_name": "KIALY",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020019127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Mudallal
• Mohamed Fawzi Mudarres
• Carrie Ann Mudd, M.D.
• Christopher David Mudd, M.D.
• Gregory D Mudd
• Linda Susan Mudd, PNP
• Melissa Sue Mudd, APRN, FNP-C
• Molly Lynn Mudd, RN, CPNP-PC
• Phillip Allen Mudd, MD
• Brian David Muegge, MD

• Family Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.