Individual provider Active NPI

Valerie Latrice Johnson, WHNP-BC

  • Women's Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1255839916
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
2017035712 Issued in MO
Practice address
4352 Manchester Ave
Saint Louis, MO 63110-2138
Phone
(314) 531-5444
NPI assigned
Jan 29, 2018
Last updated
Feb 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 2017035712 MO Primary

Addresses

Primary practice location

4352 Manchester Ave
Saint Louis, MO 63110-2138

Mailing address

4677 Tennessee Ave
Saint Louis, MO 63111-1437
Phone (314) 556-9335

Other practice location 1

4251 Forest Park Ave
Saint Louis, MO 63108-2810
Phone (314) 531-7526

Other practice location 2

401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone (314) 353-5190

Other practice location 3

24 N Sprigg St
Cape Girardeau, MO 63701-5526
Phone (314) 652-0100

Other practice location 4

3225 N Florissant Ave
Saint Louis, MO 63107-3521
Phone (314) 652-0100

Other practice location 5

6155 S Grand Blvd
Saint Louis, MO 63111-2319
Phone (314) 652-0100

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
I20180410000796 MO Practitioner - Nurse Practitioner 4880957638 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Health CentersGroup PAC ID 7911815097, 53 clinicians

Practice addresses (Care Compare)

401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone 31448116151306

4352 Manchester Ave
Saint Louis, MO 63110-2138
Phone 31448116151306

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Health Centers CurrentSince Nov 18, 2025 Accepting new patients
Planned Parenthood Great Rivers-Missouri Past Accepting new patients

Locations

401 Holly Hills Ave
Saint Louis, MO 63111
Phone (314) 353-5190

4352 Manchester Ave
Saint Louis, MO 63110
Phone (314) 371-0336

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1255839916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4677 TENNESSEE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631111437",
            "telephone_number": "314-556-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4352 MANCHESTER AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102138",
            "telephone_number": "314-531-5444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4251 Forest Park Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631082810",
            "country_code": "US",
            "telephone_number": "314-531-7526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Holly Hills Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631112410",
            "country_code": "US",
            "telephone_number": "314-353-5190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 N Sprigg St",
            "address_purpose": "LOCATION",
            "city": "Cape Girardeau",
            "state": "MO",
            "postal_code": "637015526",
            "country_code": "US",
            "telephone_number": "314-652-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3225 N Florissant Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631073521",
            "country_code": "US",
            "telephone_number": "314-652-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6155 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631112319",
            "country_code": "US",
            "telephone_number": "314-652-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VALERIE",
        "middle_name": "LATRICE",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MO",
            "license": "2017035712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.