Kendra Maxey, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2023025910 Issued in MO

Practice address

2865 Netherton Dr
Saint Louis, MO 63136-4674

Phone

(314) 653-1600

NPI assigned

Sep 11, 2023

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

David J. Pernikoff, MD, PCGroup PAC ID 7618064775, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104

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.

• David J. Pernikoff, MD, PC

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1952596314
  Medicare reassignment Care Compare group NPD

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

• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Bridgeton, MO
  • NPI 1598835308
  Care Compare affiliation

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1285411603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419161",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631419161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 NETHERTON DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631364674",
            "telephone_number": "314-653-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXEY",
        "first_name": "KENDRA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023025910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Michelle Mavers, MD
• Despina Mavridou
• Olivia R Max, MD
• Dwayne E Maxam, PT
• Maxco Home Health Care LLC
• Lucas Aaron Maxey, CRNA
• Monique Adrianne Maxey, PSYD
• Clayton Maxfield, RPH
• Daniel M Maxfield, MD
• Jennifer Maxfield

• Family Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, 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 Oct 2, 2023; 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.