MRS. KIMBERLY MARIE WICKLINE AGNP
NPI 1376200733
Nurse Practitioner - Adult Health in Ballwin, MO
About Mrs. Kimberly Marie Wickline Agnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KIMBERLY MARIE WICKLINE AGNP (NPI 1376200733) is an individual adult health provider in Ballwin, Missouri, licensed in Missouri (2021043381) and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Creve Coeur.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Kimberly Marie Wickline Agnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kimberly Wickline reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Ballwin, MO 63011
- Reassigned Medicare billing, Missouri enrollment
- 744 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 63011 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kimberly Wickline's NPI number?
The NPI number for Kimberly Wickline is 1376200733. It was assigned to this individual provider in the NPPES registry on November 19, 2021.
Where is Kimberly Wickline located?
Kimberly Wickline practices at 15945 Clayton Rd Ste 340, Ballwin, MO 63011. The listed phone number is (636) 256-5130.
What is Kimberly Wickline's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Is Kimberly Wickline enrolled in Medicare?
Yes. Kimberly Wickline is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kimberly Wickline's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Wickline reassigns Medicare benefits to Mercy Clinic East Communities (Ballwin, MO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Wickline's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kimberly Wickline accept?
Health plans from Anthem Blue Cross and Blue Shield and UnitedHealthcare list Kimberly Wickline as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kimberly Wickline was last updated on October 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Kimberly Marie Wickline, AGNP · NPI 1376200733
Adult Health physician in Ballwin, Missouri. Individual provider, active in the CMS NPPES registry since November 19, 2021.
## Identity
- **NPI:** 1376200733 (Entity type: Individual)
- **Enumerated:** November 19, 2021
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **State license:** 2021043381 (Missouri)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 15945 CLAYTON RD STE 340, Ballwin, MO 63011-2492
- **Phone:** (636) 256-5130
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Mercy Clinic East Communities (NPI 1700370061, Ballwin, MO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 9, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1376200733) · Data from the CMS NPPES public registry.