MRS. KATELYN DEADERICK APRN, FNP-C
NPI 1639892755
Nurse Practitioner - Family in Fort Leonard Wood, MO

Q: What is Katelyn Deaderick's NPI number?

The NPI number for Katelyn Deaderick is 1639892755. It was assigned to this individual provider in the NPPES registry on September 23, 2022.

Q: What is Katelyn Deaderick's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Katelyn Deaderick was last updated on December 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.

Active since September 23, 2022PECOS Enrolled

4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473(573) 596-1765 Get Directions Write a Review

NPPES record last updated: December 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 17, 2025, Nov 20, 2023, Aug 7, 2023 and 3 more (6 updates tracked since 2022).

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About Mrs. Katelyn Deaderick Aprn, Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KATELYN DEADERICK APRN, FNP-C (NPI 1639892755) is an individual family provider in Fort Leonard Wood, Missouri, licensed in Florida (APRN11024131) and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639892755

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMRS. KATELYN DEADERICKCredential: APRN, FNP-C

Location Address4430 MISSOURI AVEFort Leonard Wood, MO 65473-9098

Mailing Address4430 Missouri AveFort Leonard Wood, MO 65473-9098

Phone(573) 596-1765

Sole ProprietorNo

Enumeration DateSeptember 23, 2022

Last NPPES UpdateDecember 17, 20256 updates tracked since enumeration

NPPES CertifiedDecember 17, 2025

✔ NPI 1639892755 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in FL · APRN11024131

Also ListedRegistered Nurse · General PracticeTaxonomy 163WG0000X · License RN9581797 (FL)

4430 MISSOURI AVE, Fort Leonard Wood, MO 65473

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Katelyn Deaderick Aprn, Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65473 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JON-MARC THIBODEAU PA-C

Physician Assistant