Individual provider Active NPI

John William Molitor Jr., AGACNP

  • Acute Care Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1255878054
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2017005251 Issued in MO
Practice address
621 S New Ballas Rd Ste 297a
Saint Louis, MO 63141-8200
Phone
(314) 251-6364
NPI assigned
Jan 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2017005251 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd Ste 297a
Saint Louis, MO 63141-8200

Mailing address

621 S New Ballas Rd Ste 297a
Saint Louis, MO 63141-8200
Phone (314) 251-6364

Other practice location 1

621 S New Ballas Rd Ste 298A
Saint Louis, MO 63141-8200
Phone (314) 251-6364

Other practice location 2

701 S New Ballas Rd Ste 320
Saint Louis, MO 63141-8725
Phone (314) 251-6343

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

State licenses

LicenseStateTypeSpecialty
2012010001MOMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1255878054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 297A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418200",
            "telephone_number": "314-251-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 297A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418200",
            "telephone_number": "314-251-6364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 S New Ballas Rd Ste 298A",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418200",
            "country_code": "US",
            "telephone_number": "314-251-6364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 S New Ballas Rd Ste 320",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418725",
            "country_code": "US",
            "telephone_number": "314-251-6343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLITOR",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_suffix": "Jr.",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-31",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2017005251",
            "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 Sep 17, 2026; 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.