Active NPI
Tristen Michael Niccum, EMT
- Health Educator
- Saint Louis, MO
National Provider Identifier
1013832872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- License
- B-73659
- Practice address
- 1 Childrens PL
Saint Louis, MO 63110-1002 - Phone
- (314) 454-2694
- Fax
- (844) 231-8913
- NPI assigned
- Aug 11, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | B-73659 | MO | Primary |
Addresses
Primary practice location
1 Childrens PL
Saint Louis, MO 63110-1002
Mailing address
1 Childrens PL
Saint Louis, MO 63110-1002
Phone (314) 454-2694
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1786406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1013832872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101002",
"telephone_number": "314-454-2694",
"fax_number": "844-231-8913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101002",
"telephone_number": "314-454-2694",
"fax_number": "844-231-8913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICCUM",
"first_name": "TRISTEN",
"middle_name": "MICHAEL",
"credential": "EMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-08-11",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "MO",
"license": "B-73659",
"primary": true
}
],
"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 Aug 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.