Kelly D Paneitz, R.D., L.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2001012812 Issued in MO

Practice address

751 Sappington Bridge Rd
Missouri Baptist Hospital - Sullivan
Sullivan, MO 63080-2354

Phone

(573) 468-1347

Fax

(573) 468-1125

NPI assigned

Apr 28, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Missouri Baptist Hospital of Sullivan

  • Rural Health Clinic/Center
  • Cuba, MO
  • NPI 1396827408
  NPD (past)

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1962677252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 SAPPINGTON BRIDGE RD",
            "address_2": "MISSOURI BAPTIST HOSPITAL - SULLIVAN",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802354",
            "telephone_number": "573-468-1347",
            "fax_number": "573-468-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 SAPPINGTON BRIDGE RD",
            "address_2": "MISSOURI BAPTIST HOSPITAL - SULLIVAN",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802354",
            "telephone_number": "573-468-1347",
            "fax_number": "573-468-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANEITZ",
        "first_name": "KELLY",
        "middle_name": "D",
        "credential": "R.D., L.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2001012812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karlee Faye Nicks
• Lisa Kay Norris, PLPC
• Oluseyi Fadegbola Ogundimu, M.D.
• Alysa Oliver
• Jeffery Orr, DPT, PT
• Parkcrest Orthopedics LLC
• Christopher Allen Parks, DDS
• Parkway Pathology Group
• Patients First Health Care LLC
• Patients First Health Care LLC

• All providers in Sullivan, MO
• Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.