Active NPI
Kristin Reane Knetzer, FNP
- Family Nurse Practitioner
- Rolla, MO
National Provider Identifier
1396477956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2020034590
- Practice address
- 1050 W 10TH St
Rolla, MO 65401-2905 - Phone
- (573) 364-9000
- Fax
- (573) 202-2484
- NPI assigned
- Jun 30, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2020034590 | MO | Primary |
Addresses
Primary practice location
1050 W 10TH St
Rolla, MO 65401-2905
Mailing address
1050 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-9000
Other practice location 1
7601 Highway 137
Houston, MO 65483-2325
Phone (417) 217-6369
Other practice location 2
1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-8899
Other practice location 3
1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 364-9000
Other names 1
- Kristin Reane Mitchell
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 W 10TH St
Rolla, MO 65401-2905
Phone (573) 458-8899
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pcrmc Medical Group, Inc | Current | Accepting new patients | |
| Phelps County Regional Medical Center | Current | Accepting new patients | |
| Phelps County Regional Medical Center | Current | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
1050 W 10th St
Rolla, MO 65401
Phone (573) 364-9000
1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Rolla, MO
- NPI 1891766051
-
- Clinic/Center
- Rolla, MO
- NPI 1124237227
-
- Rural Health Clinic/Center
- Rolla, MO
- NPI 1366066037
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- Rolla, MO
- NPI 1346287455
-
- General Acute Care Hospital
- Rolla, MO
- NPI 1891766051
-
- Medicare Defined Swing Bed Hospital Unit
- Salem, MO
- NPI 1134199417
-
- Critical Access Hospital
- Salem, MO
- NPI 1639177561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739404800000",
"number": "1396477956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 W 10TH ST",
"city": "ROLLA",
"state": "MO",
"postal_code": "654012905",
"telephone_number": "573-364-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 W 10TH ST",
"city": "ROLLA",
"state": "MO",
"postal_code": "654012905",
"telephone_number": "573-364-9000",
"fax_number": "573-202-2484"
}
],
"practiceLocations": [
{
"address_1": "7601 Highway 137",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "MO",
"postal_code": "654832325",
"country_code": "US",
"telephone_number": "417-217-6369",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 W 10th St",
"address_purpose": "LOCATION",
"city": "Rolla",
"state": "MO",
"postal_code": "654012905",
"country_code": "US",
"telephone_number": "573-458-8899",
"fax_number": "573-341-5611",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 W 10th St",
"address_purpose": "LOCATION",
"city": "Rolla",
"state": "MO",
"postal_code": "654012905",
"country_code": "US",
"telephone_number": "573-364-9000",
"fax_number": "573-426-2108",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KNETZER",
"first_name": "KRISTIN",
"middle_name": "REANE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-30",
"last_updated": "2025-02-13",
"certification_date": "2025-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2020034590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTIN",
"last_name": "MITCHELL",
"middle_name": "REANE",
"credential": "FNP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Rolla, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.