Kelli P Wiethuchter, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2016039777 Issued in MO

Practice address

4921 Parkview PL
Saint Louis, MO 63110-1032

Phone

(314) 454-8134

NPI assigned

May 15, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1720515398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 WOODGATE DR",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631221029",
            "telephone_number": "314-346-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-454-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIETHUCHTER",
        "first_name": "KELLI",
        "middle_name": "P",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-15",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "201603977",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016039777",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209023299",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2016039777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "endpointDescription": "BJC",
            "affiliationName": "Barnes Jewish Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4921 Parkview Pl",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea Wieselman, MS CCC
• Arthur Stuart Wieselthier, DMD
• Erin Kathleen Wiesner, PA
• Wiethop Chiropractic, LLC
• Justin Wiethop, D.C.
• Jaclyn Wiggins, M.S., LPC
• Vickie Kay Wiggkey
• Rita Lovacia Wiggley, PA
• Anita Sue Wiggs, AGPCNP
• Andrea C Wightman, CRNA

• Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.