Nicholas Joseph Fleming, CPNP-PC

Key facts

NPI

1003695388

Entity type

Individual (NPI type 1)

Primary specialty

Pediatric Nurse Practitioner 363LP0200X

License

2023036832 (MO)

Practice address

3878 Pershall Rd
Ferguson, MO 63135-1246

Phone

(314) 738-2750

NPI assigned

Sep 26, 2023

Sex

Male

Sole proprietor

No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• SSM Health Care St. Louis Emergency Medicine Physician · Saint Charles, MO · NPI 1427002922
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: nfleming423383@direct-ehr-ssmhc.com

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 26, 2023.

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1003695388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3878 PERSHALL RD",
            "city": "FERGUSON",
            "state": "MO",
            "postal_code": "631351246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3878 PERSHALL RD",
            "city": "FERGUSON",
            "state": "MO",
            "postal_code": "631351246",
            "telephone_number": "314-738-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMING",
        "first_name": "NICHOLAS",
        "middle_name": "JOSEPH",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2023036832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shermaine Gibbs, CNA,L1MA

All providers in Ferguson, MO · Pediatric Nurse Practitioner in Missouri