Individual provider Active NPI

Dianne R Schmidt, PNP

  • Pediatric Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1194895714
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
060479 Issued in MO
Practice address
3737 N Kingshighway Blvd
Ste 209
Saint Louis, MO 63115-1736
Phone
(314) 261-5250
Fax
(314) 261-4567
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 060479 MO Primary

Addresses

Primary practice location

3737 N Kingshighway Blvd
Ste 209
Saint Louis, MO 63115-1736

Mailing address

3737 N Kingshighway Blvd
Ste 209
Saint Louis, MO 63115-1736
Phone (314) 261-5250

Other identifiers 1

IdentifierTypeStateIssuer
423447119MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichoSted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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
I20161122002056 MO Practitioner - Nurse Practitioner 5395024954 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wuca-Nash Pediatrics, LLC CurrentSince Sep 27, 2016 Accepting new patients

Locations

3737 N Kingshighway Blvd
Ste 209
Saint Louis, MO 63115
Phone (314) 261-5250

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1194895714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 N KINGSHIGHWAY BLVD",
            "address_2": "STE 209",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631151736",
            "telephone_number": "314-261-5250",
            "fax_number": "314-261-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 N KINGSHIGHWAY BLVD",
            "address_2": "STE 209",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631151736",
            "telephone_number": "314-261-5250",
            "fax_number": "314-261-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "DIANNE",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "060479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423447119",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichoSted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "3737 N Kingshighway Blvd",
            "address_2": "Ste 209",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631151736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.