Active NPI
Ebitari O Fregene, DNP
- Psychiatric/Mental Health Nurse Practitioner
- Urbandale, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 2024031047
- Practice address
- 8517 Airline Ave
Urbandale, IA 50322-2317 - Phone
- (636) 634-5668
- NPI assigned
- Aug 6, 2024
- Last updated
- Jul 22, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2024031047 | MO | Primary |
Addresses
Primary practice location
8517 Airline Ave
Urbandale, IA 50322-2317
Mailing address
115 Golden Gate Pkwy
Wentzville, MO 63385-7288
Phone (636) 634-5668
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
115 Golden Gate Pkwy
Wentzville, MO 63385-7288
8517 Airline Ave
Urbandale, IA 50322-2317
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024031047 | MO | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serenity Health LLC | Current | Accepting new patients | |
| Beth Psychiatry LLC | Past | Accepting new patients | |
| Beth Psychiatry LLC | Psychiatric/Mental Health | Past | Accepting new patients |
| St. Louis Internal Medicine Inc | Past | Accepting new patients |
Locations
5000 Cedar Plaza Pkwy
Ste 350
Saint Louis, MO 63128
Phone (314) 843-4333
4905 Mexico Rd
Ste 400
Saint Peters, MO 63376
Phone (314) 862-4840
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatry Physician
- Saint Peters, MO
- NPI 1104569151
-
- Clinic/Center
- Urbandale, IA
- NPI 1467271304
-
- Adult Mental Health Clinic/Center
- Frankfort, IL
- NPI 1043198062
-
- Psychiatric/Mental Health Nurse Practitioner
- Frankfort, IL
- NPI 1063193829
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1104856442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784678400000",
"number": "1003646795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 GOLDEN GATE PKWY",
"city": "WENTZVILLE",
"state": "MO",
"postal_code": "633857288",
"telephone_number": "636-634-5668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8517 AIRLINE AVE",
"city": "URBANDALE",
"state": "IA",
"postal_code": "503222317",
"telephone_number": "636-634-5668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREGENE",
"first_name": "EBITARI",
"middle_name": "O",
"credential": "DNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-06",
"last_updated": "2026-07-22",
"certification_date": "2026-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MO",
"license": "2024031047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Urbandale, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.