Kristina Lynn Wadley, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

2022036717 Issued in MO

Practice address

304 Teaco Rd
Kennett, MO 63857-3266

Phone

(573) 559-3591

NPI assigned

Sep 20, 2022

Last updated

Sep 20, 2022By the provider in NPPES

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Missouri Health NetworkGroup PAC ID 6507818044, 19 clinicians

McPherson Medical and Diagnostic LLCGroup PAC ID 5698773539, 88 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020
• Great River Medical Center Hospital, Blytheville, AR, CCN 040069
• Mercy Hospital Stoddard Hospital, Dexter, MO, CCN 260160

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristina.wadley.1@14764.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• McPherson Medical & Diagnostic, LLC

  dba Malden Family Clinic and Diagnostic

  • Clinic/Center
  • Malden, MO
  • NPI 1003407883
  Medicare reassignment Care Compare group NPD
• Southeast Missouri Health Network

  • Federally Qualified Health Center (FQHC)
  • New Madrid, MO
  • NPI 1609095975
  Medicare reassignment Care Compare group NPD
• McPherson Medical & Diagnostic, LLC

  • Family Medicine Physician
  • Kennett, MO
  • NPI 1124679774
  NPD
• McPherson Medical & Diagnostic, LLC

  dba McPherson Medical and Diagnostic, LLC

  • Family Medicine Physician
  • Kennett, MO
  • NPI 1679706956
  NPD
• Southeast Missouri Health Network

  dba NMCC School Based Health Center

  • Federally Qualified Health Center (FQHC)
  • New Madrid, MO
  • NPI 1790531119
  NPD
• McPherson Medical & Diagnostic, LLC

  • Family Medicine Physician
  • Steele, MO
  • NPI 1164440806
  NPD (past)
• Southeast Missouri Health Network

  dba Portageville Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Portageville, MO
  • NPI 1780803916
  NPD (past)

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

• Southeast Health Center of Stoddard County, LLC

  dba Mercy Hospital Stoddard

  • General Acute Care Hospital
  • Dexter, MO
  • NPI 1801990825
  Care Compare affiliation
• Mississippi County Hospital System

  dba Great River Medical Center

  • General Acute Care Hospital
  • Blytheville, AR
  • NPI 1316180748
  Care Compare affiliation
• St Bernards Hospital Inc

  dba St Bernards Medical Center

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1922043686
  Care Compare affiliation

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1124741715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 TEACO RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573266",
            "telephone_number": "573-559-3591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 TEACO RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573266",
            "telephone_number": "573-559-3591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADLEY",
        "first_name": "KRISTINA",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2022036717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Visiting Nurse Association of Southeast Missouri Inc
• Visiting Nurse Association of Southeast Missouri Inc
• Visiting Nurse Association of Southeast Missouri Inc
• Visiting Nurse Association of Southeast Missouri, Inc.
• Kara Vonruden, MHRW
• Donna Wagoner
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0190)
• Wal-Mart Stores East, LP (Vision Center 30-0190)
• Kimberly Wallace, LRN
• Madisen Wallace

• Primary Care Nurse Practitioner in Kennett, MO
• Providers in Kennett, MO by specialty
• Primary Care Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.