Individual provider Active NPI

Richard Ernest Kinsey, R.N., B.C., F.N.P.

  • Family Nurse Practitioner
  • Cape Girardeau, MO
National Provider Identifier
1467457960
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
107463 Issued in MO
Practice address
150 S Mount Auburn Rd
Suite 418
Cape Girardeau, MO 63703-4911
Phone
(573) 332-6000
NPI assigned
Jun 20, 2005
Last updated
Mar 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 107463 MO Primary

Addresses

Primary practice location

150 S Mount Auburn Rd
Suite 418
Cape Girardeau, MO 63703-4911

Mailing address

1332 Perryville Rd
Cape Girardeau, MO 63701-3808
Phone (573) 335-1830

Other identifiers 1

IdentifierTypeStateIssuer
425702305MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
107463MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midtown Family Medical Center Past Accepting new patients
Aesthetic Dermatologic Surgery PastSince Mar 15, 2002 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1467457960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 PERRYVILLE RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637013808",
            "telephone_number": "573-335-1830",
            "fax_number": "573-243-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S MOUNT AUBURN RD",
            "address_2": "SUITE 418",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034911",
            "telephone_number": "573-332-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSEY",
        "first_name": "RICHARD",
        "middle_name": "ERNEST",
        "credential": "R.N., B.C., F.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "107463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425702305",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.