Kimberly Dawn Autry, AGNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AG05210083 Issued in MO

Practice address

6406 Wise Ave
Saint Louis, MO 63139-3315

Phone

(314) 636-4891

NPI assigned

Jun 7, 2021

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unity Hospice GSL LLCGroup PAC ID 6406037274, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Unity Hospice GSL, LLC

  • Community Based Hospice Care Agency
  • Saint Louis, MO
  • NPI 1114220043

  MO

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1265009369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 FERNWOOD DR",
            "city": "HOUSE SPRINGS",
            "state": "MO",
            "postal_code": "630511768",
            "telephone_number": "314-719-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6406 WISE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631393315",
            "telephone_number": "314-636-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUTRY",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2024-07-10",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "AG05210083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shontel Sheree Austin, CNA
• Tricia M. Austin, PHD, PT, ATC
• Autonomous Case Management of St Louis
• Daniel M Autry, D.M.D.
• David Carl Autry, PA
• Autumn Day Home Healthcare LLC
• Auxiliary in-Home Services LLC
• Sarah Auyong, OTD, OTR/L
• Ava Home Care LLC
• Avalcare Inc

• All providers in Saint Louis, MO
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.