Individual provider Active NPI

Rachel Flick, FNP-C

  • Family Nurse Practitioner
  • Fenton, MO
National Provider Identifier
1225514722
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018016871 Issued in MO
Practice address
44 Fenton PLZ
Fenton, MO 63026-4110
Phone
(618) 560-9177
NPI assigned
Jul 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209017864 IL
Family Nurse Practitioner 363LF0000X 2018016871 MO Primary

Addresses

Primary practice location

44 Fenton PLZ
Fenton, MO 63026-4110

Mailing address

44 Fenton PLZ
Fenton, MO 63026-4110
Phone (618) 560-9177

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209017864ILMDFamily Nurse Practitioner
2018016871MOMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1225514722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 FENTON PLZ",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630264110",
            "telephone_number": "618-560-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 FENTON PLZ",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630264110",
            "telephone_number": "618-560-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLICK",
        "first_name": "RACHEL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209017864",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018016871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.