Misty A Kindle

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

117134 Issued in MO

Practice address

1103 W Liberty St
Farmington, MO 63640-1921

Phone

(573) 756-6751

Fax

(573) 756-6807

NPI assigned

Aug 23, 2006

Last updated

Oct 28, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Misty A Shaw Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Mineral Area Osteopathic Hospital Inc

  dba Mineral Area Regional Medical Center

  • Nurse Practitioner
  • Farmington, MO
  • NPI 1124220637
  NPD (past)
• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1285664268
  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1720194426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR",
            "address_2": "STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "573-756-6751",
            "fax_number": "573-756-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 W LIBERTY ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401921",
            "telephone_number": "573-756-6751",
            "fax_number": "573-756-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDLE",
        "first_name": "MISTY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "117134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISTY",
            "last_name": "SHAW",
            "middle_name": "A",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristin Keutzer
• Azamuddin Khaja, M.D.
• George Killian, LPC
• Rene Killian, LCSW
• Karl D Killion, DO
• Charles Clayton Kindlesparger Jr.
• Thomas J Kirisits, DPM
• Laura Kirkley, LMSW
• Scott David Kirkley, MD
• Norman Carl Kissinger, LPC

• Family Nurse Practitioner in Farmington, MO
• Providers in Farmington, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.