Individual provider Active NPI

Kristin Leigh Wheeler, M.D.

  • Obstetrics & Gynecology Physician
  • Florissant, MO
National Provider Identifier
1407295314
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2013019767 Issued in MO
Practice address
1120 Shackelford Rd
Florissant, MO 63031-4369
Phone
(314) 921-4420
NPI assigned
Jun 25, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2013019767 MO Primary

Addresses

Primary practice location

1120 Shackelford Rd
Florissant, MO 63031-4369

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kwheeler212362@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170928001139 MO Practitioner - Obstetrics/Gynecology 2769610534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Tennessee, HSC, College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

1120 Shackelford Rd
Florissant, MO 63031-4369
Phone (314) 921-4420

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2013019767MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St Louis CurrentSince Sep 24, 2017 Accepting new patients
SSM Health Care St. Louis CurrentSince Sep 24, 2017 Accepting new patients
SSM Medical Group Inc. CurrentSince Aug 1, 2018 Accepting new patients
SSM Medical Group, Inc. CurrentSince Aug 1, 2018 Accepting new patients
Missouri Baptist Medical Center Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1120 Shackelford Rd
Florissant, MO 63031
Phone (314) 830-5805

14021 New Halls Ferry Rd
Florissant, MO 63033
Phone (314) 839-0910

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: kwheeler212362@direct-ehr-ssmhc.com

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407295314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 SHACKELFORD RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630314369",
            "telephone_number": "314-921-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "KRISTIN",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2022-07-21",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2013019767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwheeler212362@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kwheeler212362@direct-ehr-ssmhc.com",
            "address_1": "1120 Shackelford Rd",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630314369",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1120 Shackelford Rd",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630314369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

Verify at the official NPI Registry.