Individual provider Active NPI

Kristin Waugh, FNP

  • Family Nurse Practitioner
  • Harrisonville, MO
National Provider Identifier
1639544802
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2015038465 Issued in MO
Practice address
2820 E Rock Haven Rd Ste 100
Harrisonville, MO 64701-4413
Phone
(816) 380-3582
Fax
(816) 380-6964
NPI assigned
Dec 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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 2015038465 MO Primary

Addresses

Primary practice location

2820 E Rock Haven Rd Ste 100
Harrisonville, MO 64701-4413

Mailing address

2820 E Rock Haven Rd Ste 100
Harrisonville, MO 64701-4413
Phone (816) 380-3582

Other practice location 1

2700 Clay Edwards Dr
Suite 120
North Kansas City, MO 64116-3251
Phone (816) 346-7400

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
I20170109000057 MO Practitioner - Nurse Practitioner 4284924960 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Jan 4, 2022 Accepting new patients
HCR Manorcare Medical Services of Florida LLC CurrentSince Jul 8, 2019 Accepting new patients
Citizens Memorial Healthcare CurrentSince Oct 18, 2023 Accepting new patients
Orthopedic Health of Kansas City P.C. CurrentSince May 11, 2020 Accepting new patients
Citizens Memorial Healthcare CurrentSince Oct 18, 2023 Accepting new patients

Locations

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

118 W Dallas St
Buffalo, MO 65622
Phone (417) 345-6101

1200 Graham Rd
Florissant, MO 63031
Phone (314) 383-6555

1950 Diamond Pkwy
Ste 100
North Kansas City, MO 64116
Phone (816) 561-3003

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

363 E Old Route 66
Strafford, MO 65757
Phone (417) 736-9175

Interoperability endpoints

  • Direct secure messaging: kristin.waugh.1@21731.direct.athenahealth.com

Organizations & group practices 5

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": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1639544802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 E ROCK HAVEN RD STE 100",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647014413",
            "telephone_number": "816-380-3582",
            "fax_number": "816-380-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 E ROCK HAVEN RD STE 100",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647014413",
            "telephone_number": "816-380-3582",
            "fax_number": "816-380-6964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Clay Edwards Dr",
            "address_2": "Suite 120",
            "address_purpose": "LOCATION",
            "city": "North Kansas City",
            "state": "MO",
            "postal_code": "641163251",
            "country_code": "US",
            "telephone_number": "816-346-7400",
            "fax_number": "816-346-7104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAUGH",
        "first_name": "KRISTIN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-14",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015038465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonville, MO

Sources for this page

Verify at the official NPI Registry.