Kelly Ann Esposito, NP-C

Key facts

NPI

1154862225

Entity type

Individual (NPI type 1)

Primary specialty

Primary Care Nurse Practitioner 363LP2300X

License

2017006134 (MO)

Practice address

1040 N Mason Rd Ste 115
Saint Louis, MO 63141-6361

Phone

(314) 542-0606

NPI assigned

Mar 9, 2017

Sex

Female

Sole proprietor

Yes

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.

• Associated Specialists in Medicine, PC Allergy & Immunology Physician · Saint Louis, MO · NPI 1306062955
  Medicare reassignment NPD MO

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4817/brand/1/csg/1/fhir/r4
• Direct secure messaging: kelly.esposito.1@4817.direct.athenahealth.com

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 9, 2017.

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1154862225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 N MASON RD STE 115",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416361",
            "telephone_number": "314-542-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 N MASON RD STE 115",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416361",
            "telephone_number": "314-542-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPOSITO",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2017006134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Saint Louis, MO · Primary Care Nurse Practitioner in Missouri