Individual provider Active NPI

Kelly Ann Esposito, NP-C

  • Primary Care Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1154862225
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
2017006134 Issued in MO
Practice address
1040 N Mason Rd Ste 115
Saint Louis, MO 63141-6361
Phone
(314) 542-0606
NPI assigned
Mar 9, 2017
Last updated
Mar 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 2017006134 MO Primary

Addresses

Primary practice location

1040 N Mason Rd Ste 115
Saint Louis, MO 63141-6361

Mailing address

1040 N Mason Rd Ste 115
Saint Louis, MO 63141-6361
Phone (314) 542-0606

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
I20170817003064 MO Practitioner - Nurse Practitioner 4981976479 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017006134MOMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Specialists in Medicine, PC CurrentSince Jun 22, 2017 Accepting new patients

Locations

1040 N Mason Rd
Ste 115
Saint Louis, MO 63141
Phone (314) 542-0606

969 N Mason Rd
Ste 240
Saint Louis, MO 63141
Phone (314) 542-0606

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4817/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kelly.esposito.1@4817.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1154862225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 N MASON RD STE 115",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416361",
            "telephone_number": "314-542-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 N MASON RD STE 115",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416361",
            "telephone_number": "314-542-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPOSITO",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2017006134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.