Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1083842454 Individual Practitioner Female Practitioner

Dr. Kimberly N Hackney , DO

Pediatrics • O Fallon, MO

Professional Overview & Biography Verified Profile Summary

Dr. Kimberly Hackney, DO is a registered healthcare professional specializing in Pediatrics in O Fallon, MO. Practice services are available at 300 WINDING WOODS DR STE 120 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

300 Winding Woods Dr Ste 120

O Fallon, MO 633664772

Telephone 6369787902

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in O Fallon, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 4.0 Yrs
State Avg: 19.4 Yrs
Regional Practice Density
20 Specialists

Practicing in O Fallon, MO (1616 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License MO 2010037113

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics - Pediatric Emergency Medicine

NUCC Taxonomy Code: 2080P0204X

State License MO 2010037113

A pediatrician who has special qualifications to manage emergencies in infants and children.

Pediatrics - Pediatric Emergency Medicine

NUCC Taxonomy Code: 2080P0204X

State License KS 05-35901

A pediatrician who has special qualifications to manage emergencies in infants and children.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1083842454 (MO)
Commercial Insurance / Payer ID Railroad Medicare
P01296531 (MO)
Commercial Insurance / Payer ID Illinois Medical Assistance Program
PAYEE 1 (IL)

Secondary Practice Locations

615 S New Ballas Rd, Suite 6006b

Saint Louis, MO 631418221

Phone: 3142516299

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Brooke Meyer , RN, MSN, CPNP

Nurse Practitioner - Pediatrics

NPI 1104216142

Registered Nurse, Master of Science in Nursing, Certified Pediatric Nurse Practitioner

NPI 1124769427

Doctor of Medicine (M.D.)

Alyssa Fairchild , CPNP-PC

Nurse Practitioner - Pediatrics

NPI 1720610355

CPNPPC

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
NPI Profile Active November 28, 2017

NPI status registered as active in NPPES database

📍
Updated Business Mailing Address November 28, 2017

Registered at 300 WINDING WOODS DR STE 120, O FALLON, MO 633664772 (Tel: 6369787902)

📍
Updated Practice Location November 28, 2017

Registered at 615 S NEW BALLAS RD, SUITE 6006B, SAINT LOUIS, MO 631418221 (Tel: 3142516299)

👤
Provider Name / Credentials Updated November 28, 2017

Recorded as KIMBERLY HACKNEY, D.O.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 28, 2017

Pediatrics (License #2010037113 in MO)

NPI Profile Active July 01, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location July 01, 2014

Registered at 615 S NEW BALLAS RD, SUITE 6006B, SAINT LOUIS, MO 631418221 (Tel: 3142516299)

📍
Updated Business Mailing Address July 01, 2014

Registered at 621 S NEW BALLAS RD, SUITE 6006B, SAINT LOUIS, MO 631418232 (Tel: 3142516299)

👤
Provider Name / Credentials Updated July 01, 2014

Recorded as KIMBERLY HACKNEY, D.O.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 01, 2014

Pediatrics (License #2010037113 in MO)

🟢
Initial NPI Registration & Enumeration June 24, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1083842454
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 24, 2009
Last Update: November 28, 2017
Sole Proprietor: No

Mailing Address

300 Winding Woods Dr Ste 120

O Fallon, MO 633664772

Phone: 6369787902

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.