Kristin Suzanne Wheeler Guethle, NP-C
Individual provider Active NPI Family Nurse Practitioner · Dexter, MO
NPI 1255801247 · NPPES record last updated Dec 3, 2018
Key facts
- NPI
- 1255801247
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2018036146 (MO)
- Practice address
- 1200 N One Mile Rd
Dexter, MO 63841-1000 - Phone
- (573) 421-3134
- NPI assigned
- Dec 3, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dexter Hospital, LLC
Southeast Health Center of Stoddard County LLC
Practice addresses (Care Compare)
1200 N One Mile Rd
Dexter, MO 63841-1000
1300 N One Mile
Suite 3
Dexter, MO 63841-1000
2025 W Business US Hwy 60
Dexter, MO 63841-2879
Phone (573) 614-4600
Hospital & facility affiliations
- Mercy Hospital Stoddard
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190221001046 | MO | Practitioner - Nurse Practitioner | 1254679038 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018036146 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Health Center of Stoddard County, LLC | Current | Accepting new patients | |
| Southeast Health Center of Stoddard County, LLC | Current |
Accepting new patients | |
| Southeast Health Center of Stoddard County LLC | Current |
Accepting new patients |
Locations
1200 N One Mile Rd
Dexter, MO 63841
Phone (573) 614-1900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2018036146 | MO | Yes |
Addresses
Primary practice location
1200 N One Mile Rd
Dexter, MO 63841-1000
Mailing address
1200 N One Mile Rd
Dexter, MO 63841-1000
Phone (573) 421-3134
Other providers in Dexter, MO
- Natalie Gargas
- Neal W Garner
- Generations Health Systems of Dexter, LLC
- Tracy Jo Graves
- Stacey A Grays
- Harps Food Stores, Inc
- Teddy C Hatfield
- Health Services of Dexter, Inc
- Jacob Heath
- Tracy Hedrick
All providers in Dexter, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.