Individual provider Active NPI

Kristin Presley, FNP

  • Family Nurse Practitioner
  • Sikeston, MO
National Provider Identifier
1922501923
Registry record updated Mar 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017037323 Issued in MO
Practice address
1008 N Main St
Sikeston, MO 63801-5044
Phone
(573) 472-6001
Fax
(573) 472-6006
NPI assigned
Mar 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2018

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 2017037323 MO Primary

Addresses

Primary practice location

1008 N Main St
Sikeston, MO 63801-5044

Mailing address

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 472-6001

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
I20180320001630 MO Practitioner - Nurse Practitioner 2062774698 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017037323MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri Delta Medical Center CurrentSince Mar 20, 2018 Accepting new patients
Missouri Delta Medical Center CurrentSince Mar 20, 2018 Accepting new patients

Locations

1403 E Marshall St
Charleston, MO 63834
Phone (573) 683-2327

412 W Broadwater Rd
Malden, MO 63863
Phone (573) 990-1002

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

Organizations & group practices 2

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": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1922501923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-472-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-472-6001",
            "fax_number": "573-472-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESLEY",
        "first_name": "KRISTIN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017037323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sikeston, MO

Sources for this page

Verify at the official NPI Registry.