Individual provider Active NPI

Kristen Davidson O'Dell, NP

  • Nurse Practitioner
  • Saint Peters, MO
National Provider Identifier
1245909928
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2025038536 Issued in MO
Practice address
114 Piper Hill Dr Ste 103
Saint Peters, MO 63376-1661
Phone
(636) 442-5035
Fax
(636) 442-5036
NPI assigned
Sep 7, 2021
Last updated
Nov 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 196098 AZ
Nurse Practitioner 363L00000X 2025038536 MO Primary

Addresses

Primary practice location

114 Piper Hill Dr Ste 103
Saint Peters, MO 63376-1661

Mailing address

114 Piper Hill Dr Ste 103
Saint Peters, MO 63376-1661
Phone (636) 442-5035

Other practice location 1

114 Piper Hill Dr Ste 201
Saint Peters, MO 63376-1661
Phone (636) 442-5035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211018000706 AZ Practitioner - Nurse Practitioner 6709284037 Reassigns benefits to 1 organization
I20251029004627 MO Practitioner - Nurse Practitioner 6709284037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pro Pain LLCGroup PAC ID 0941563225, 6 clinicians

Practice addresses (Care Compare)

114 Piper Hill Dr
Suite 201
Saint Peters, MO 63376-1661
Phone (636) 442-5035

4881 E Grant Rd
Tucson, AZ 85712-2704
Phone (520) 829-6776

Merit-based Incentive Payment System (MIPS)

Final score
45.68 of 100Reported as group
Quality
40.49
Promoting interoperability
0
Improvement activities
30
Cost
74.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
196098AZMDNurse Practitioner
2025038536MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Pain LLC CurrentSince Oct 23, 2025 Accepting new patients
Pro Pain LLC CurrentSince Oct 23, 2025 Accepting new patients
Pain Institute of Southern Arizona Pisa PC CurrentSince Sep 27, 2021 Accepting new patients
Pain Institute of Southern Arizona Pisa PC CurrentSince Sep 27, 2021 Accepting new patients

Locations

4582 N 1st Ave
Ste 170
Tucson, AZ 85718
Phone (520) 505-3766

4881 E Grant Rd
Tucson, AZ 85712
Phone (520) 829-6776

4881 E Grant Rd
Ste 101
Tucson, AZ 85712
Phone (520) 829-6776

114 Piper Hill Dr
Ste 103
Saint Peters, MO 63376
Phone (314) 690-1525

114 Piper Hill Dr
Ste 201
Saint Peters, MO 63376
Phone (314) 690-1525

4800 Mexico Rd
Ste 101
Saint Peters, MO 63376
Phone (636) 442-5035

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72783

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1245909928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 PIPER HILL DR STE 103",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761661",
            "telephone_number": "636-442-5035",
            "fax_number": "636-442-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 PIPER HILL DR STE 103",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761661",
            "telephone_number": "636-442-5035",
            "fax_number": "636-442-5036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Piper Hill Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633761661",
            "country_code": "US",
            "telephone_number": "636-442-5035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DELL",
        "first_name": "KRISTEN",
        "middle_name": "DAVIDSON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "196098",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2025038536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.