Individual provider Active NPI

Kael Ann Murphy Pettis, MD

  • Obstetrics & Gynecology Physician
  • Chesterfield, MO
National Provider Identifier
1831681626
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2022010838 Issued in MO
Practice address
226 S Woods Mill Rd Ste 68W
Chesterfield, MO 63017-3665
Phone
(314) 205-6788
Fax
(314) 590-5954
NPI assigned
Jun 6, 2018
Last updated
Jun 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2018018365 MO
Obstetrics & Gynecology Physician 207V00000X 2022010838 MO Primary

Addresses

Primary practice location

226 S Woods Mill Rd Ste 68W
Chesterfield, MO 63017-3665

Mailing address

226 S Woods Mill Rd Ste 68W
Chesterfield, MO 63017-3665
Phone (314) 205-6788

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221021001495 MO Practitioner - Obstetrics/Gynecology 1658620224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Creighton University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West County Women's Healthcare, LLCGroup PAC ID 2961534417, 10 clinicians

Practice addresses (Care Compare)

222 S Woods Mill Rd
Suite 360
Chesterfield, MO 63017-3625
Phone (636) 486-0179

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
West County Women's Healthcare, LLC Single Specialty CurrentSince Sep 1, 2022 Accepting new patients
Cardiothoracic Surgery, LLC Single Specialty PastSince Sep 1, 2022 Accepting new patients
St. Lukes Episcopal-Presbyterian Hospital Single Specialty Past Accepting new patients
Premier Medical Physicians LLC Single Specialty PastSince May 1, 2018 Accepting new patients
Medical Weight Management Specialists, LLC Single Specialty PastSince Jun 1, 2017 Accepting new patients

Locations

111 Saint Lukes Center Dr
Ste 44
Chesterfield, MO 63017
Phone (314) 576-2424

121 Saint Lukes Center Dr
Chesterfield, MO 63017
Phone (314) 434-3278

222 S Woods Mill Rd
Ste 360
Chesterfield, MO 63017
Phone (314) 576-1001

226 S Woods Mill Rd
Ste 68W
Chesterfield, MO 63017
Phone (314) 205-6788

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1831681626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 S WOODS MILL RD STE 68W",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173665",
            "telephone_number": "314-205-6788",
            "fax_number": "314-590-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 S WOODS MILL RD STE 68W",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173665",
            "telephone_number": "314-205-6788",
            "fax_number": "314-590-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURPHY PETTIS",
        "first_name": "KAEL",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2018018365",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2022010838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.