Active NPI
Demetrices Carter Jr., RRT
- Critical Care Registered Respiratory Therapist
- Saint Louis, MO
National Provider Identifier
1013309178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Registered Respiratory Therapist
- License
- 2009035077
- Practice address
- 11960 Westline Industrial Dr
Saint Louis, MO 63146-3209 - Phone
- (314) 275-7444
- NPI assigned
- Feb 26, 2015
- Last updated
- Feb 26, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Registered Respiratory Therapist | 2279C0205X | 2009035077 | MO | Primary |
| Critical Care Registered Respiratory Therapist | 2279C0205X | 194.008539 | IL |
Addresses
Primary practice location
11960 Westline Industrial Dr
Saint Louis, MO 63146-3209
Mailing address
11960 Westline Industrial Dr
Saint Louis, MO 63146-3209
Phone (314) 275-7444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 194.008539 | IL | MD | Critical Care Registered Respiratory Therapist |
| 2009035077 | MO | MD | Critical Care Registered Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424908800000",
"number": "1013309178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11960 WESTLINE INDUSTRIAL DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631463209",
"telephone_number": "314-275-7444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11960 WESTLINE INDUSTRIAL DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631463209",
"telephone_number": "314-275-7444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "DEMETRICES",
"name_suffix": "Jr.",
"credential": "RRT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-02-26",
"last_updated": "2015-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "2279C0205X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Registered, Critical Care",
"state": "MO",
"license": "2009035077",
"primary": true
},
{
"code": "2279C0205X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Registered, Critical Care",
"state": "IL",
"license": "194.008539",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.