Waltina J Kisner, MSN, APN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

140376 Issued in MO

Practice address

3231 S National Ave Ste 440
Springfield, MO 65807-7304

Phone

(417) 888-5660

NPI assigned

Nov 20, 2007

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

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

Practice roles

Locations

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 Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Hollister, MO
  • NPI 1053350454
  NPD
• Skaggs Community Hospital Association

  • Rural Health Clinic/Center
  • Forsyth, MO
  • NPI 1861423683
  NPD
• Cape Neurological Surgeons, P. C.

  • Specialist
  • Cape Girardeau, MO
  • NPI 1629176664
  NPD (past)

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1225219009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 S NATIONAL AVE STE 440",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077304",
            "telephone_number": "417-888-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 S NATIONAL AVE STE 440",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077304",
            "telephone_number": "417-888-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISNER",
        "first_name": "WALTINA",
        "middle_name": "J",
        "credential": "MSN, APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-20",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "140376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225219009",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE WEST",
            "identifier": "431560263",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR CB9013",
            "identifier": "P00826746",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183029758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spencer Park Kirk, D.O.
• Kiley Kirkpatrick
• Eddie L Kirsch, PA
• Erin Michelle Kirsch
• Malcom Daniel Kirtley, HIS
• Richard Wayne Kissell, M.D.
• Lena Kissi Mensah
• Sandra Kitterman-Horne, LPC
• Jenna M Kitts, MS, LPC
• Regina Beth Kizer, DNP, CNM

• Adult Health Nurse Practitioner in Springfield, MO
• Providers in Springfield, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.