KIM MARIE WATERHOUSE (M.D.) – Pediatric Allergy/Immunology Physician, NPI 1730384322
Pediatric Allergy/Immunology Physician
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Profile Insights
NPPES metrics only — not quality of care.
115 ALLERGY/IMMUNOLOGY in MO
Provider Addresses for KIM MARIE WATERHOUSE (M.D.)
1101 HIGHWAY K
O FALLON, MO 633668431
Phone: (636) 379-6363
Fax: (636) 379-1297
Type: Location
1020 Hitt St
Columbia, MO 652120001
Phone: (573) 882-6921
Fax: (573) 882-1154
Type: Location
PO BOX 955534
SAINT LOUIS, MO 631955534
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 17 Open Payments records for all available years, with a total value of $770.
Total Amount is formed as General ($770) + Research ($0) + Ownership ($0) = $770.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($244).
Total Amount
$770
General + Research + Ownership
Payments
17
Total payment records
General Amount
$770
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $244 |
| GENZYME CORPORATION | $182 |
| Regeneron Healthcare Solutions, Inc. | $131 |
| GlaxoSmithKline, LLC. | $97 |
| ABBVIE INC. | $68 |
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: 2011-09-13
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110913000918 | I | Allergy/Immunology | MO | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63366)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ALLERGY/IMMUNOLOGY | MO | 95004 | Injection of allergenic extracts into skin, accessed through the skin | 980 | 16 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| A L L E R G Y/ I M M U N O L O G Y | MO | |
| Internal Medicine, Allergy/Immunology | MO | |
| Nurse Practitioner | MO | |
| A L L E R G Y/ I M M U N O L O G Y | MO | |
| Physician Assistant | CA | |
| Pediatric Medicine, Allergy/Immunology, Internal Medicine | MO | |
| Allergy/Immunology, Internal Medicine | MO | |
| Internal Medicine | MO | |
| - | MO | |
| Physician Assistant | MO |
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