MELISSA KAY WALLIS (NPI# 1346705993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346705993 |
| Entity Type | Individual |
| Full Name | MELISSA KAY WALLIS |
| Credential | AGNP-C |
| Practice Address |
10012 Kennerly Rd Saint Louis MO 63128-2042 |
| Mailing Address |
10012 Kennerly Rd Ste 400 Saint Louis MO 63128-2197 |
| Practice Telephone | 3145435999 |
| Practice Fax Number | 3145435994 |
| Mailing Telephone | 3145435999 |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2019-02-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 041456271 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363L00000X | Nurse Practitioner | 2013023808 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10012 KENNERLY RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-2042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154323376 | Minxiang Gu | Internal Medicine | 10012 Kennerly Rd, Suite 100, Saint Louis, MO 63128-2197 | 2005-06-01 |
| 1154935880 | Carol Bivins | Nurse Practitioner | 10012 Kennerly Rd, Saint Louis, MO 63128-2042 | 2020-09-01 |
| 1255833323 | Cameron Rousseau | Physician Assistant | 10012 Kennerly Rd, Saint Louis, MO 63128-2197 | 2018-03-05 |
| 1649721192 | Brittany Shoults | Nurse Practitioner | 10012 Kennerly Rd, Saint Louis, MO 63128-2197 | 2016-10-19 |
| 1366891137 | Emily Grace Peters | Nurse Practitioner | 10012 Kennerly Rd, Suite 202, Saint Louis, MO 63128-2197 | 2016-06-12 |
| 1194171033 | Rhonda G Haag | Nurse Practitioner | 10012 Kennerly Rd, Ste 101, Saint Louis, MO 63128-2197 | 2016-05-10 |
| 1669831293 | Kate E Lee | Nurse Practitioner | 10012 Kennerly Rd, Suite 300, Saint Louis, MO 63128-2197 | 2016-02-10 |
| 1477911857 | Aaron Rippelmeyer | Nurse Practitioner | 10012 Kennerly Rd, Suite 300, Saint Louis, MO 63128-2197 | 2016-02-01 |
| 1124492483 | Lesley Maria Endermuhle | Nurse Practitioner | 10012 Kennerly Rd, Ste 305, Saint Louis, MO 63128-2197 | 2015-11-23 |
| 1114391067 | Amy Elizabeth Moran | Nurse Practitioner | 10012 Kennerly Rd, Suite 305, Saint Louis, MO 63128-2197 | 2015-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184221160 | Zachary Wade Orr | Nurse Practitioner | 1622 S 18th St, Saint Louis, MO 63104-2504 | 2020-10-02 |
| 1073128518 | Christen Rincker | Nurse Practitioner | 2343 Hickory St, Saint Louis, MO 63104-2418 | 2020-09-11 |
| 1861026650 | Kelly Ann Clark | Nurse Practitioner | 4590 Childrens Pl, Saint Louis, MO 63110-1020 | 2020-03-02 |
| 1902444292 | Tony Duy Le | Nurse Practitioner | 1251 Hyannis Dr, Saint Louis, MO 63146-4639 | 2019-12-17 |
| 1114562154 | Lisa Pezold | Nurse Practitioner | 2029 Woodland Pkwy, Saint Louis, MO 63146-4267 | 2019-11-13 |
| 1255806527 | Rachel Ramos | Nurse Practitioner | 11133 Dunn Rd Ste 209e, Saint Louis, MO 63136-6163 | 2018-10-12 |
| 1851893341 | Jessica Rae Britt | Nurse Practitioner | 1 Barnes Jewish Hospital Plz Fl 10, 10th Fl, Saint Louis, MO 63110-1003 | 2018-03-01 |
| 1952816449 | Loreta Shahinaj | Nurse Practitioner | 12700 Southfork Rd Ste 270, Saint Louis, MO 63128-3201 | 2017-12-06 |
| 1689183832 | Natalie Michelle Barone | Nurse Practitioner | 3023 N Ballas Rd Ste 630, Saint Louis, MO 63131-2361 | 2017-09-20 |
| 1194240986 | Laura Kaesser | Nurse Practitioner | 11125 Dunn Rd Ste 204, Saint Louis, MO 63136-6188 | 2017-08-14 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.