Individual provider Active NPI

Monique Elyse Tindle, APRN-BC

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1174609077
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
147230 Issued in MO
Practice address
4850 Lemay Ferry Rd
Suite 210
Saint Louis, MO 63129-1576
Phone
(314) 892-6565
Fax
(314) 892-4828
NPI assigned
Oct 31, 2006
Last updated
Jun 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 147230 MO Primary

Addresses

Primary practice location

4850 Lemay Ferry Rd
Suite 210
Saint Louis, MO 63129-1576

Mailing address

9735 Landmark Parkway Dr
Ste 200
Saint Louis, MO 63127-1646
Phone (314) 892-6565

Other identifiers 1

IdentifierTypeStateIssuer
42402501MedicaidMO

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
I20070302000011 MO Practitioner - Nurse Practitioner 1951403450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Pulmonology - St. Louis, LLCGroup PAC ID 2365599925, 23 clinicians

Practice addresses (Care Compare)

12700 Southfork Rd
Suite 280
Saint Louis, MO 63128-3287
Phone (314) 892-6565

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Pulmonology - St. Louis, LLC CurrentSince Jan 1, 2020 Accepting new patients
Simran Behavioral Health Past Accepting new patients
Kirpa LLC Past Accepting new patients

Locations

12700 Southfork Rd
Ste 280
Saint Louis, MO 63128
Phone (314) 525-4990

621 S New Ballas Rd
Ste 228A
Saint Louis, MO 63141
Phone (314) 251-4966

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, 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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1174609077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 LANDMARK PARKWAY DR",
            "address_2": "STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271646",
            "telephone_number": "314-892-6565",
            "fax_number": "314-892-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 LEMAY FERRY RD",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291576",
            "telephone_number": "314-892-6565",
            "fax_number": "314-892-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINDLE",
        "first_name": "MONIQUE",
        "middle_name": "ELYSE",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "147230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42402501",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.