Provider Demographics
NPI:1770534158
Name:CARNES, KASEY L (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KASEY
Middle Name:L
Last Name:CARNES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:KASEY
Other - Middle Name:L
Other - Last Name:SCMITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1390 US HIGHWAY 61 STE G1000
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-4136
Mailing Address - Country:US
Mailing Address - Phone:636-933-7400
Mailing Address - Fax:
Practice Address - Street 1:1390 US HIGHWAY 61 STE G1000
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4136
Practice Address - Country:US
Practice Address - Phone:636-933-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AS0400X
MO2005037008363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204634OtherBLUE CROSS BLUE SHIELD
MO732725OtherHEALTHLINK
MO732725OtherHEALTHLINK
MO000097284Medicare ID - Type Unspecified