Individual provider Active NPI

Lauren Elise Carqueville, FNP-BC

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1063851830
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018003099 Issued in MO
Practice address
1001 S Kirkwood Rd Ste 300
Saint Louis, MO 63122-7250
Phone
(314) 525-4225
Fax
(314) 525-4229
NPI assigned
Jun 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209010482 IL
Family Nurse Practitioner 363LF0000X 2018003099 MO Primary

Addresses

Primary practice location

1001 S Kirkwood Rd Ste 300
Saint Louis, MO 63122-7250

Mailing address

1001 S Kirkwood Rd Ste 300
Saint Louis, MO 63122-7250
Phone (314) 525-4225

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
I20181211001289 MO Practitioner - Nurse Practitioner 6002058930 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy East Ambulatory Services LLCGroup PAC ID 2365739240, 102 clinicians

Practice addresses (Care Compare)

714 Gravois Rd
Suite 100
Fenton, MO 63026-7723
Phone (636) 492-2245

Hospital & facility affiliations

  • SSM Health St Mary'S Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018003099MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Jan 1, 2020 Accepting new patients
Mercy Clinic East Communities CurrentSince Jan 1, 2020 Accepting new patients
Mercy East Ambulatory Services LLC CurrentSince Mar 5, 2023 Accepting new patients

Locations

714 Gravois Rd
Ste 100
Fenton, MO 63026
Phone (636) 326-6100

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

1001 S Kirkwood Rd
Ste 300
Saint Louis, MO 63122
Phone (314) 525-4225

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

9735 Landmark Parkway Dr
Ste 200
Saint Louis, MO 63127
Phone (314) 525-1887

5425 Southfield Ctr
Saint Louis, MO 63123
Phone (314) 543-5258

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1063851830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S KIRKWOOD RD STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631227250",
            "telephone_number": "314-525-4225",
            "fax_number": "314-525-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S KIRKWOOD RD STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631227250",
            "telephone_number": "314-525-4225",
            "fax_number": "314-525-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARQUEVILLE",
        "first_name": "LAUREN",
        "middle_name": "ELISE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209010482",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018003099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.