Individual provider Active NPI

Lee Ann Kluth, DNP

  • Nurse Practitioner
  • Branson, MO
National Provider Identifier
1992560049
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2022046990 Issued in MO
Practice address
1150 State Highway 248 Ste 200
Branson, MO 65616-4186
Phone
(417) 336-4112
Fax
(417) 335-4684
NPI assigned
Feb 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2022046990 MO Primary

Addresses

Primary practice location

1150 State Highway 248 Ste 200
Branson, MO 65616-4186

Mailing address

PO Box 505673
Saint Louis, MO 63150-5673
Phone (417) 730-6430

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
I20240325002300 MO Practitioner - Nurse Practitioner 7012354178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skaggs Community Hospital AssociationGroup PAC ID 5092624320, 222 clinicians

Practice addresses (Care Compare)

1150 State Hwy 248
Suite 200
Branson, MO 65616-4186
Phone (417) 336-4112

Hospital & facility affiliations

  • Cox Medical Center Branson Hospital, Branson, MO, CCN 260094
  • Cox Medical Centers Hospital, Springfield, MO, CCN 260040

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Skaggs Community Hospital Association CurrentSince Apr 22, 2024 Accepting new patients
Skaggs Community Hospital Association CurrentSince Apr 22, 2024 Accepting new patients
Skaggs Community Hospital Association Past Accepting new patients

Locations

1150 State Highway 248
Ste 200
Branson, MO 65616
Phone (417) 336-4112

1150 State Highway 248
Branson, MO 65616
Phone (417) 336-4112

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1992560049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505673",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505673",
            "telephone_number": "417-730-6430",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 STATE HIGHWAY 248 STE 200",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656164186",
            "telephone_number": "417-336-4112",
            "fax_number": "417-335-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUTH",
        "first_name": "LEE",
        "middle_name": "ANN",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2022046990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

Verify at the official NPI Registry.