Active NPI
Allison Marie Kertz, FNP
- Family Nurse Practitioner
- Saint Louis, MO
National Provider Identifier
1104989029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2013021628
- Practice address
- 1 Brookings Dr
Saint Louis, MO 63130-4862 - Phone
- (314) 935-6649
- Fax
- (314) 935-8515
- NPI assigned
- Dec 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2013021628 | MO | Primary |
Addresses
Primary practice location
1 Brookings Dr
Saint Louis, MO 63130-4862
Mailing address
1201 Brookings Dr
C B 1201
Saint Louis, MO 63130
Phone (314) 935-6666
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013021628 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baystate Medical Practices, Inc | Past | Accepting new patients |
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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Springfield, MA
- NPI 1548205909
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475020800000",
"number": "1104989029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 BROOKINGS DR",
"address_2": "C B 1201",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63130",
"telephone_number": "314-935-6666",
"fax_number": "314-935-5781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BROOKINGS DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631304862",
"telephone_number": "314-935-6649",
"fax_number": "314-935-8515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERTZ",
"first_name": "ALLISON",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-19",
"last_updated": "2016-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2013021628",
"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 Sep 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.