Individual provider Active NPI

Tara Elizabeth Reber

  • Point of Service
  • Saint Louis, MO
National Provider Identifier
1083508907
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
LC014637630 Issued in MO
Practice address
5850 Macklind Ave Unit 273
Saint Louis, MO 63109-3569
Phone
(314) 757-8885
NPI assigned
Jun 5, 2025
Last updated
Jun 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X LC014637630 MO Primary

Addresses

Primary practice location

5850 Macklind Ave Unit 273
Saint Louis, MO 63109-3569

Mailing address

5850 Macklind Ave Unit 273
Saint Louis, MO 63109-3569
Phone (314) 757-8885

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

State licenses

LicenseStateTypeSpecialty
LC014637630MOMDPoint of Service

NPI Registry JSON

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1083508907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 MACKLIND AVE UNIT 273",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631093569",
            "telephone_number": "314-757-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 MACKLIND AVE UNIT 273",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631093569",
            "telephone_number": "314-757-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBER",
        "first_name": "TARA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "MO",
            "license": "LC014637630",
            "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 Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.