Individual provider Active NPI

Magda Shewaye Nur, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1114720893
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2025009570 Issued in MO
Practice address
4574 Valmeyer Dr
Saint Louis, MO 63128-2458
Phone
(314) 482-4200
NPI assigned
Mar 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2025009570 MO Primary

Addresses

Primary practice location

4574 Valmeyer Dr
Saint Louis, MO 63128-2458

Mailing address

4574 Valmeyer Dr
Saint Louis, MO 63128-2458
Phone (314) 482-4200

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
I20251013000917 MO Practitioner - Nurse Practitioner 7416444781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Kansas City, School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
One Behavioral of MissouriGroup PAC ID 6204313364, 19 clinicians

Practice addresses (Care Compare)

5000 Cedar Plaza Pkwy
Suite 320
Saint Louis, MO 63128-3841
Phone (314) 200-1366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Health LLC CurrentSince Sep 25, 2025 Accepting new patients
One Behavioral of Missouri CurrentSince Jan 1, 2026 Accepting new patients
St. Louis Internal Medicine Inc Past Accepting new patients

Locations

5000 Cedar Plaza Pkwy
Ste 350
Saint Louis, MO 63128
Phone (314) 843-4333

11709 Old Ballas Rd
Ste 104
Saint Louis, MO 63141
Phone (314) 329-2036

5000 Cedar Plaza Pkwy
Ste 320
Saint Louis, MO 63128
Phone (669) 900-9251

11709 Old Ballas Rd
Ste 105
Saint Louis, MO 63141
Phone (314) 200-1366

4905 Mexico Rd
Ste 400
Saint Peters, MO 63376
Phone (314) 860-9979

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.

NPI Registry JSON

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

{
    "created_epoch": "1743206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1114720893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4574 VALMEYER DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282458",
            "telephone_number": "314-482-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4574 VALMEYER DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282458",
            "telephone_number": "314-482-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUR",
        "first_name": "MAGDA",
        "middle_name": "SHEWAYE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-29",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2025009570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.