Individual provider Active NPI

Kaitlin Rhodes Thorson, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Chesterfield, MO
National Provider Identifier
1114591336
Registry record updated May 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2021017273 Issued in MO
Practice address
232 S Woods Mill Rd # 6500
Chesterfield, MO 63017-3485
Phone
(314) 205-6965
NPI assigned
May 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 2015003836 MO
Adult Health Nurse Practitioner 363LA2200X 2021017273 MO Primary

Addresses

Primary practice location

232 S Woods Mill Rd # 6500
Chesterfield, MO 63017-3485

Mailing address

232 S Woods Mill Rd # 6500
Chesterfield, MO 63017-3485
Phone (314) 205-6965

Other names 1

  • Kaitlin Marie Rhodes Former name

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
I20210715000828 MO Practitioner - Nurse Practitioner 7315349222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5772

3023 N Ballas Rd
Suite 200D
Saint Louis, MO 63131-2328
Phone (314) 996-7272

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015003836MOMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St. Lukes Medical Group Past Accepting new patients

Organizations & group practices 3

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": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621036800000",
    "number": "1114591336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 S WOODS MILL RD # 6500",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173485",
            "telephone_number": "314-205-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 S WOODS MILL RD # 6500",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173485",
            "telephone_number": "314-205-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORSON",
        "first_name": "KAITLIN",
        "middle_name": "RHODES",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-15",
        "certification_date": "2021-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MO",
            "license": "2015003836",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2021017273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "RHODES",
            "middle_name": "MARIE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.