NPIMap

Organization Active NPI

University of Missouri St. Louis

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1104047141
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
134958 Issued in MO
Legal business name
UNIVERSITY OF MISSOURI ST. LOUIS
Practice address
1 University Blvd
Millenium Student Center 131
Saint Louis, MO 63121-4400
Phone
(314) 516-5671
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Nancy Magnuson, DSN, APRN, CS, FNP
Title
Asst. Vice Provost Student Affairs
Phone
(314) 516-5671

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 134958 MO Primary

Addresses

Primary practice location

1 University Blvd
Millenium Student Center 131
Saint Louis, MO 63121-4400

Mailing address

1 University Blvd
Millenium Student Center 131
Saint Louis, MO 63121-4400
Phone (314) 516-5671

Other names 1

  • University Health Services Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0962897Curators of Univ of Mo - Umsl Health Services1 University Blvd, MSC 131, Saint Louis, MO 63121Provider-performed microscopyJul 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
Univ Phys Infectious Di51 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Locations

1 University Blvd
#131
Saint Louis, MO 63121
Phone (314) 516-5671

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104047141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY BLVD",
            "address_2": "MILLENIUM STUDENT CENTER 131",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631214400",
            "telephone_number": "314-516-5671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY BLVD",
            "address_2": "MILLENIUM STUDENT CENTER 131",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631214400",
            "telephone_number": "314-516-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF MISSOURI ST. LOUIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAGNUSON",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "ASST. VICE PROVOST STUDENT AFFAIRS",
        "authorized_official_telephone_number": "314-516-5671",
        "authorized_official_credential": "DSN, APRN, CS, FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "134958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Health Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.