Individual provider Active NPI

Kayla Kremer, PNP

  • Pediatric Nurse Practitioner
  • O Fallon, MO
National Provider Identifier
1891005427
Registry record updated Oct 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
048392 Issued in MO
Practice address
102 Laura K Dr
O Fallon, MO 63366-3990
Phone
(636) 379-9633
NPI assigned
Oct 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 048392 MO Primary

Addresses

Primary practice location

102 Laura K Dr
O Fallon, MO 63366-3990

Mailing address

102 Laura K Dr
O Fallon, MO 63366-3990
Phone (636) 379-9633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1287187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287187200000",
    "number": "1891005427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 LAURA K DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633663990",
            "telephone_number": "636-379-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 LAURA K DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633663990",
            "telephone_number": "636-379-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREMER",
        "first_name": "KAYLA",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-16",
        "last_updated": "2010-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "048392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.