Individual provider Active NPI

Maureen E Huber, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1093123028
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2014025545 Issued in MO
Practice address
13303 Tesson Ferry Rd Ste 45
Saint Louis, MO 63128-4062
Phone
(314) 748-5917
Fax
(314) 748-5919
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2007004149 MO
Family Nurse Practitioner 363LF0000X 2014025545 MO Primary

Addresses

Primary practice location

13303 Tesson Ferry Rd Ste 45
Saint Louis, MO 63128-4062

Mailing address

13303 Tesson Ferry Rd Ste 45
Saint Louis, MO 63128-4062
Phone (314) 748-5917

Other practice location 1

12700 Southfork Rd
Ste 280
Saint Louis, MO 63128-3201
Phone (314) 525-4990

Other practice location 2

12700 Southfork Rd
Ste 280
Saint Louis, MO 63128-3201
Phone (314) 525-4990

Other names 1

  • Maureen E Bredenkamp Former name

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
I20140818002285 MO Practitioner - Nurse Practitioner 0749407559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Multispecialty Group IncGroup PAC ID 1658365572, 118 clinicians

Practice addresses (Care Compare)

13303 Tesson Ferry Rd
Suite 45
Saint Louis, MO 63128-4062
Phone (314) 748-5917

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007004149MOMDRegistered Nurse
2014025545MOMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: maureen.huber.p1@direct.essehealth.nextgenshare.com

Organizations & group practices 1

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 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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1093123028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13303 TESSON FERRY RD STE 45",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631284062",
            "telephone_number": "314-748-5917",
            "fax_number": "314-748-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13303 TESSON FERRY RD STE 45",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631284062",
            "telephone_number": "314-748-5917",
            "fax_number": "314-748-5919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12700 Southfork Rd",
            "address_2": "STE 280",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631283201",
            "country_code": "US",
            "telephone_number": "314-525-4990",
            "fax_number": "314-525-4926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12700 Southfork Rd",
            "address_2": "STE 280",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631283201",
            "country_code": "US",
            "telephone_number": "314-525-4990",
            "fax_number": "314-525-4926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBER",
        "first_name": "MAUREEN",
        "middle_name": "E",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2007004149",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2014025545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAUREEN",
            "last_name": "BREDENKAMP",
            "middle_name": "E",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.