Individual provider Active NPI

Amanda Kulikowski, RN

  • Chronic Care Clinical Nurse Specialist
  • Saint Louis, MO
National Provider Identifier
1265071831
Registry record updated Dec 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Chronic Care Clinical Nurse SpecialistTaxonomy code 364SC2300X
License
21900917 Issued in MO
Practice address
6400 Clayton Rd Ste 303
Saint Louis, MO 63117-1850
Phone
(314) 647-6666
Fax
(314) 647-2600
NPI assigned
Dec 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chronic Care Clinical Nurse Specialist 364SC2300X 21900917 MO Primary

Addresses

Primary practice location

6400 Clayton Rd Ste 303
Saint Louis, MO 63117-1850

Mailing address

6400 Clayton Rd Ste 303
Saint Louis, MO 63117-1850
Phone (314) 647-6666

Other identifiers 1

IdentifierTypeStateIssuer
2006019384OtherMOMISSOURI LICENSE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amanda@claytonmedstl.com Direct

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
21900917MOMDChronic Care Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1265071831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 CLAYTON RD STE 303",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171850",
            "telephone_number": "314-647-6666",
            "fax_number": "314-647-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 CLAYTON RD STE 303",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171850",
            "telephone_number": "314-647-6666",
            "fax_number": "314-647-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULIKOWSKI",
        "first_name": "AMANDA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-31",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SC2300X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Chronic Care",
            "state": "MO",
            "license": "21900917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI LICENSE NUMBER",
            "identifier": "2006019384",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amanda@claytonmedstl.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6400 Clayton Rd Ste 303",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631171850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Dec 31, 2019; 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.