Individual provider Active NPI

Debra K Gremminger, FNP

  • Family Nurse Practitioner
  • Crystal City, MO
National Provider Identifier
1023265147
Registry record updated Aug 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
154686 Issued in MO
Practice address
1400 US Highway 61 South
Crystal City, MO 63019
Phone
(636) 933-1111
NPI assigned
Aug 20, 2008
Last updated
Aug 20, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 154686 MO Primary

Addresses

Primary practice location

1400 US Highway 61 South
Crystal City, MO 63019

Mailing address

109 Glenfield Dr
Festus, MO 63028-4623
Phone (636) 933-1111

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081112000089 MO Practitioner - Nurse Practitioner 3577622166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital JeffersonGroup PAC ID 1254248271, 10 clinicians

Practice addresses (Care Compare)

1400 US Hwy 61
Festus, MO 63028-4100
Phone (636) 933-1111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
154686MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Jefferson CurrentSince Aug 20, 2019 Accepting new patients
Mercy Hospital Jefferson CurrentSince Aug 20, 2019 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Past Accepting new patients

Locations

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219190400000",
    "number": "1023265147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 GLENFIELD DR",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284623",
            "telephone_number": "636-933-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61 SOUTH",
            "city": "CRYSTAL CITY",
            "state": "MO",
            "postal_code": "63019",
            "telephone_number": "636-933-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREMMINGER",
        "first_name": "DEBRA",
        "middle_name": "K",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2008-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "154686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal City, MO

Sources for this page

Verify at the official NPI Registry.