KIMBERLY DAWN AUTRY (AGNP-C) – Adult Health Nurse Practitioner, NPI 1265009369

KIMBERLY DAWN AUTRY (AGNP-C) is a healthcare provider. based in House springs, Missouri. specializing in NURSE PRACTITIONER. They hold the professional credentials AGNP-C. They hold a License No. AG05210083 (MO). The NPI Number for KIMBERLY DAWN AUTRY (AGNP-C) is 1265009369

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLY DAWN AUTRY (AGNP-C)
NPI
1265009369
Phone
(314) 719-9974
Address
4301 FERNWOOD DR
Enumeration Date
7 June 2021
Last Update Date
10 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3146458648
Graduation Year
2020 (6 years ago)
PAC ID
0143625574
Group Practice PAC ID
6406037274
Professional Enrollment ID
I20210824001873
Address ID
MO631393315SA6406XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

7,023 NURSE PRACTITIONER in MO

Provider Addresses for KIMBERLY DAWN AUTRY (AGNP-C)

  • 4301 FERNWOOD DR

    HOUSE SPRINGS, MO 630511768

    Phone: (314) 719-9974

    Type: Mailing

  • 6406 WISE AVE

    SAINT LOUIS, MO 631393315

    Phone: (314) 636-4891

    Type: Location

  • 3015 N BALLAS RD

    SAINT LOUIS, MO 631312329

    Phone: (314) 996-5000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-08-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210824001873INurse PractitionerMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99350Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes18437$0
99310Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes4718$0
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes1612$0
View full utilization report →

Insurance plans in this area (ZIP 63051)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406037274View full group profile
NameSpecialtyState
Nurse PractitionerMO
Nurse PractitionerMO

Reviews

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Frequently asked questions

How do payers reference KIMBERLY DAWN AUTRY (AGNP-C)?
For KIMBERLY DAWN AUTRY (AGNP-C), use NPI 1265009369 as the unique 10-digit identifier.
Is KIMBERLY DAWN AUTRY (AGNP-C) still an active registrant?
KIMBERLY DAWN AUTRY (AGNP-C) carries an active NPI according to the public dataset.
How would a patient describe KIMBERLY DAWN AUTRY (AGNP-C)'s focus?
For KIMBERLY DAWN AUTRY (AGNP-C), the primary taxonomy reads as Adult Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Missouri is KIMBERLY DAWN AUTRY (AGNP-C) registered?
Use House Springs, Missouri as the headline location for KIMBERLY DAWN AUTRY (AGNP-C) here.
Does KIMBERLY DAWN AUTRY (AGNP-C) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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