Individual provider Active NPI

Lindsey C Duesterhaus, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1063783967
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2006024135 Issued in MO
Practice address
10024 Watson Rd
Saint Louis, MO 63126-1829
Phone
(314) 919-2500
Fax
(314) 919-2577
NPI assigned
Jan 24, 2012
Last updated
Nov 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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 2006024135 MO Primary

Addresses

Primary practice location

10024 Watson Rd
Saint Louis, MO 63126-1829

Mailing address

10024 Watson Rd
Saint Louis, MO 63126-1829
Phone (314) 919-2500

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
I20120413000693 MO Practitioner - Nurse Practitioner 7012178262 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2006024135MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Aco Clinical Services Inc CurrentSince Nov 8, 2021 Accepting new patients
St Louis Neuropathy & Pain Relie PastSince Jan 1, 2016 Accepting new patients

Locations

15740 South Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 735-4268

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

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.

NPI Registry JSON

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

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1063783967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10024 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631261829",
            "telephone_number": "314-919-2500",
            "fax_number": "314-919-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10024 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631261829",
            "telephone_number": "314-919-2500",
            "fax_number": "314-919-2577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUESTERHAUS",
        "first_name": "LINDSEY",
        "middle_name": "C",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-24",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2006024135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.