Individual provider Active NPI

Christina M Reser, FNP-BC

  • Family Nurse Practitioner
  • Independence, MO
National Provider Identifier
1477907830
Registry record updated Jul 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016009883 Issued in MO
Practice address
16912 E Hart Ave
Independence, MO 64055-3040
Phone
(816) 529-1011
NPI assigned
Apr 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2017

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 2016009883 MO Primary

Addresses

Primary practice location

16912 E Hart Ave
Independence, MO 64055-3040

Mailing address

10900 Nuckols Rd
Ste 110
Glen Allen, VA 23060-9246
Phone (804) 396-6412

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160818001934 MO Practitioner - Nurse Practitioner 9133414998 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ketamine and IV Therapy Clinic of Nwa LLC Family CurrentSince May 1, 2025 Accepting new patients

Locations

101 Grant Pl
Ste C
Lowell, AR 72745
Phone (479) 313-2382

1631 NE Douglas St
Lees Summit, MO 64086
Phone (816) 381-2050

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1477907830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 NUCKOLS RD",
            "address_2": "STE 110",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609246",
            "telephone_number": "804-396-6412",
            "fax_number": "804-482-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16912 E HART AVE",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640553040",
            "telephone_number": "816-529-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESER",
        "first_name": "CHRISTINA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-21",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016009883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.