Active NPI
Staisy Ester Young, WHNP
- Adult Health Nurse Practitioner
- Bridgeton, MO
National Provider Identifier
1174769517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 2002031370
- Practice address
- 12035 Chaparral Dr
Bridgeton, MO 63044-2824 - Phone
- (314) 494-2584
- NPI assigned
- Jan 6, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 2002031370 | MO | |
| Adult Health Nurse Practitioner | 363LA2200X | 2002031370 | MO | Primary |
Addresses
Primary practice location
12035 Chaparral Dr
Bridgeton, MO 63044-2824
Mailing address
2643 Blue Heron
Forissant, MO 63031
Phone (314) 494-2584
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of St Louis Division of Fiscal Management | Past | Accepting new patients | |
| Riggs Community Health Center Inc | Past | Accepting new patients |
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.
-
dba John C. Murphy Health Center
- Federally Qualified Health Center (FQHC)
- Berkeley, MO
- NPI 1184519506
-
- Federally Qualified Health Center (FQHC)
- Lafayette, IN
- NPI 1386660900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496966400000",
"number": "1174769517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2643 BLUE HERON",
"city": "FORISSANT",
"state": "MO",
"postal_code": "63031",
"telephone_number": "314-494-2584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12035 CHAPARRAL DR",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "630442824",
"telephone_number": "314-494-2584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "STAISY",
"middle_name": "ESTER",
"name_prefix": "Ms.",
"credential": "WHNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-06",
"last_updated": "2017-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "MO",
"license": "2002031370",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MO",
"license": "2002031370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.