Active NPI
Laura Nicole Becker, MD
- Pediatrics Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2023007603
- Practice address
- 1465 S Grand Blvd
Saint Louis, MO 63104-1003 - Phone
- (314) 268-4095
- NPI assigned
- Feb 29, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 30430 | NE | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 30430 | NE | |
| Pediatrics Physician | 208000000X | 2023007603 | MO | Primary |
Addresses
Primary practice location
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Mailing address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 268-4095
Other practice location 1
900 Washington Rd
West Point, NY 10996-1109
Phone (845) 938-4114
Other practice location 2
3551 Roger Brooke Dr
San Antonio, TX 78234-4504
Phone (210) 916-9928
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30430 | NE | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Cardinal Glennon Children'S Hospital | Pediatrics | Current | Accepting new patients |
| SSM Cardinal Glennon Childrens Hospital | Pediatrics | Current | Accepting new patients |
| SSM Health Care St Louis | Current | Accepting new patients | |
| SSM Cardinal Glennon Childrens Hospital | Pediatrics | Current | Accepting new patients |
| SSM Health Care St. Louis | Past | Accepting new patients |
Locations
7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189
6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070
Interoperability endpoints
- lbecker454097@direct-ehr-ssmhc.com
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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- Fenton, MO
- NPI 1275586174
-
- Pediatrics Physician
- Warrenton, MO
- NPI 1962573212
-
- General Acute Care Hospital
- Fenton, MO
- NPI 1851496152
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684713600000",
"number": "1023478344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "314-268-4095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "314-268-4095"
}
],
"practiceLocations": [
{
"address_1": "900 Washington Rd",
"address_purpose": "LOCATION",
"city": "West Point",
"state": "NY",
"postal_code": "109961109",
"country_code": "US",
"telephone_number": "845-938-4114",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3551 Roger Brooke Dr",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782344504",
"country_code": "US",
"telephone_number": "210-916-9928",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BECKER",
"first_name": "LAURA",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-29",
"last_updated": "2023-05-22",
"certification_date": "2023-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NE",
"license": "30430",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NE",
"license": "30430",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2023007603",
"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 May 22, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.