Kristine Wall, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2024015564 Issued in MO

Practice address

1511 Christy Dr
Jefferson City, MO 65101-2854

Phone

(573) 632-2777

Fax

(573) 632-2769

NPI assigned

May 3, 2024

Last updated

May 3, 2024By the provider in NPPES

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Group practices

Community Health Ctr of Central MissouriGroup PAC ID 2062456015, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Missouri Health Care Hospital, Columbia, MO, CCN 260141
• SSM Health St. Mary's Hospital - Jefferson City Hospital, Jefferson City, MO, CCN 260011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristine.wall.p1@direct.chccmo.nextgenshare.com

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.

• Community Health Ctr of Central Missouri

  • Federally Qualified Health Center (FQHC)
  • Linn, MO
  • NPI 1538213244
  Medicare reassignment Care Compare group NPD
• Community Health Ctr of Central Missouri

  dba Community Health Center of Central Missouri-Christy Drive

  • Federally Qualified Health Center (FQHC)
  • Jefferson City, MO
  • NPI 1972001386
  NPD
• Community Health Ctr of Central Missouri

  dba Community Health Center of Central Missouri

  • Federally Qualified Health Center (FQHC)
  • Fulton, MO
  • NPI 1316282239
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Curators of the University of Missouri

  dba Capital Region Medical Center

  • General Acute Care Hospital
  • Jefferson City, MO
  • NPI 1174597892
  Care Compare affiliation
• Curators of the University of Missouri

  dba University of Missouri Health Care

  • General Acute Care Hospital
  • Columbia, MO
  • NPI 1699769901
  Care Compare affiliation
• SSM Regional Health Services

  dba SSM Health St. Mary's Hospital Jefferson City

  • General Acute Care Hospital
  • Jefferson City, MO
  • NPI 1518065523
  Care Compare affiliation

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1275380628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 104780",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651104780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 CHRISTY DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651012854",
            "telephone_number": "573-632-2777",
            "fax_number": "573-632-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "KRISTINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-03",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2024015564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walk Easy LLC
• Skylar Danae Walk, OTD
• Jaime L Walker, AU.D.
• Melanie Ann Walker, LPC
• Riley L Walker, MS, LAT, ATC
• Brittany Walsh, M.S. CCC-SLP
• Walter Pfitzinger, DDS, PC No. 2 (Riverside Family Dental Center)
• Joseph L Wang, M.D.
• Robert P. Wankum, M.D.
• Lana Elaine Wanstreet, CRNA

• Family Nurse Practitioner in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.