Individual provider Active NPI

Ronnie Ray Bivens, RN

  • Registered Nurse
  • Saint Louis, MO
National Provider Identifier
1194449223
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
2015032403 Issued in MO
Practice address
5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265
Phone
(314) 367-5820
Fax
(314) 367-7010
NPI assigned
Oct 3, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2015032403 MO Primary

Addresses

Primary practice location

5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265

Mailing address

5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265
Phone (314) 367-5820

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2015032403MOMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1194449223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5471 DR MARTIN LUTHER KING DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631124265",
            "telephone_number": "314-367-5820",
            "fax_number": "314-367-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5471 DR MARTIN LUTHER KING DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631124265",
            "telephone_number": "314-367-5820",
            "fax_number": "314-367-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIVENS",
        "first_name": "RONNIE",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2015032403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.