Individual provider Active NPI

Ranita A Walker, CPT

  • Phlebotomy Technician
  • East Saint Louis, IL
National Provider Identifier
1124615257
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
License
F2X4T9Q2 Issued in MO
Practice address
514 N 57TH St
East Saint Louis, IL 62203-1304
Phone
(618) 772-2721
NPI assigned
Dec 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X F2X4T9Q2 MO Primary

Addresses

Primary practice location

514 N 57TH St
East Saint Louis, IL 62203-1304

Mailing address

514 N 57TH St
East Saint Louis, IL 62203-1304
Phone (618) 772-2721

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

State licenses

LicenseStateTypeSpecialty
F2X4T9Q2MOMDPhlebotomy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Diagnostics CurrentSince Jan 31, 2021 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.

NPI Registry JSON

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1124615257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 N 57TH ST",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622031304",
            "telephone_number": "618-772-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 N 57TH ST",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622031304",
            "telephone_number": "618-772-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "RANITA",
        "middle_name": "A",
        "credential": "CPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-22",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "MO",
            "license": "F2X4T9Q2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Saint Louis, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.