Colleen Elizabeth Tepen, AGNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

2003005382 Issued in MO

Practice address

2920 Fee Fee Rd
Maryland Heights, MO 63043-1915

Phone

(314) 291-0121

NPI assigned

Feb 13, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Aco Clinical Services IncGroup PAC ID 6901188572, 159 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ctepen35494@evernorth.direct-ci.com

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.

• Mercy Aco Clinical Services Inc

  • Neurology Physician
  • Chesterfield, MO
  • NPI 1063965093
  Medicare reassignment Care Compare group
• Vpa PC

  • Family Medicine Physician
  • Saint Louis, MO
  • NPI 1760706337
  Medicare reassignment NPD
• Vpa PC

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1578363362
  NPD

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

{
    "created_epoch": "1423785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1215328174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 NUCKOLS RD STE 110",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609246",
            "telephone_number": "314-779-1929",
            "fax_number": "833-610-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 FEE FEE RD",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630431915",
            "telephone_number": "314-291-0121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Lauderdale Dr",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232383933",
            "country_code": "US",
            "telephone_number": "804-430-9272",
            "fax_number": "804-804-2334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEPEN",
        "first_name": "COLLEEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-13",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2015003907",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2003005382",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2015003907",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2003005382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420020056",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Swift
• Everlyn J Tarus
• Caitlin Tegerdine
• Danielle Tenbruggencate, PLPC
• Lauren Ashley Tenny, LPC
• Ashley Marie Terbrock, FNP
• Sheri Nicole Terry, OTR/L
• The Ranken-Jordan Home for Convalescent Crippled Children
• The Smile Company Dental Care LLC
• The Smile Company, Sleep Solutions, LLC

• Gerontology Nurse Practitioner in Maryland Heights, MO
• Providers in Maryland Heights, MO by specialty
• Gerontology Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.