Individual provider Active NPI

Christina Renee Coleman, APRN, PNP-PC

  • Pediatric Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1114752607
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
202428353 Issued in MO
Practice address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone
(314) 577-5600
NPI assigned
Sep 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 202428353 MO Primary

Addresses

Primary practice location

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Mailing address

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 577-5600

Other names 1

  • Christina Renee Beetz 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
I20240925000573 MO Practitioner - Nurse Practitioner 2062953482 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202428353MOMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Cardinal Glennon Childrens Hospital CurrentSince Sep 22, 2024 Accepting new patients
SSM Cardinal Glennon Children's Hospital CurrentSince Sep 22, 2024 Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189

3878 Pershall Rd
Saint Louis, MO 63135
Phone (314) 344-6021

Interoperability endpoints

  • Direct secure messaging: cbeetz193841@direct-ehr-ssmhc.com

Organizations & group practices 2

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": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1114752607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "CHRISTINA",
        "middle_name": "RENEE",
        "credential": "APRN, PNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-04",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "202428353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "BEETZ",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.