Individual provider Active NPI

Kristen Lynn Main, FNP-C

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1083163505
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016013313 Issued in MO
Practice address
2121 Barrett Station Rd
Saint Louis, MO 63131-1606
Phone
(314) 394-1923
NPI assigned
Sep 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 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 2016013313 MO Primary

Addresses

Primary practice location

2121 Barrett Station Rd
Saint Louis, MO 63131-1606

Mailing address

12639 Old Tesson Rd Ste 100
Saint Louis, MO 63128-2711
Phone (314) 849-0311

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Kristen.main@direct.signature.nextgenshare.com

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
I20161117002379 MO Practitioner - Nurse Practitioner 5092094847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Saint Louis University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Medical Group IncGroup PAC ID 4880598291, 40 clinicians

Practice addresses (Care Compare)

1011 Bowles Ave
Suite 100
Fenton, MO 63026-2387
Phone (314) 849-0311

12639 Old Tesson Rd
Saint Louis, MO 63128-2786
Phone 31484903112384

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016013313MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Medical Group, Inc CurrentSince Dec 1, 2021 Accepting new patients
Signature Medical Group, Inc CurrentSince Dec 1, 2021 Accepting new patients

Locations

121 Saint Lukes Center Dr
Ste 302
Chesterfield, MO 63017
Phone (314) 205-6399

1011 Bowles Ave
Ste 100
Fenton, MO 63026

9323 Phoenix Village Pkwy
O Fallon, MO 63368
Phone (636) 561-0871

12639 Old Tesson Rd
Ste 115
Saint Louis, MO 63128
Phone (314) 842-8655

10435 Clayton Rd
Ste 120
Saint Louis, MO 63131
Phone (314) 442-4452

12639 Old Tesson Rd
Ste 100
Saint Louis, MO 63128

Organizations & group practices 2

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 2

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": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1083163505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON RD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282711",
            "telephone_number": "314-849-0311",
            "fax_number": "314-849-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 BARRETT STATION RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311606",
            "telephone_number": "314-394-1923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIN",
        "first_name": "KRISTEN",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-26",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016013313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kristen.main@direct.signature.nextgenshare.com",
            "affiliation": "N",
            "address_1": "9323 Phoenix Village Pkwy",
            "city": "O Fallon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633684281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.