Individual provider Active NPI

Kayla Michele Richter, PA-C

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1255965422
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2020007938 Issued in MO
Practice address
2015 Maplewood Commons Dr
Saint Louis, MO 63143-1003
Phone
(314) 293-4023
NPI assigned
Feb 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 2020007938 MO Primary

Addresses

Primary practice location

2015 Maplewood Commons Dr
Saint Louis, MO 63143-1003

Mailing address

2015 Maplewood Commons Dr
Saint Louis, MO 63143-1003
Phone (314) 293-4023

Other practice location 1

12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000

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
I20200403000596 MO Practitioner - Physician Assistant 5092144543 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2020007938MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Apr 1, 2020 Accepting new patients
SSM Health Care St Louis CurrentSince Dec 15, 2020 Accepting new patients
Cep America LLC CurrentSince Apr 1, 2020 Accepting new patients
SSM Health Care St. Louis CurrentSince Dec 15, 2020 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

100 Medical Plz
Lake St Louis, MO 63367
Phone (636) 625-5200

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

Organizations & group practices 6

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": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1255965422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 MAPLEWOOD COMMONS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631431003",
            "telephone_number": "314-293-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 MAPLEWOOD COMMONS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631431003",
            "telephone_number": "314-293-4023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12303 De Paul Dr",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442512",
            "country_code": "US",
            "telephone_number": "314-344-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHTER",
        "first_name": "KAYLA",
        "middle_name": "MICHELE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-26",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2020007938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.