Individual provider Active NPI

Madison Devenuto

  • Family Nurse Practitioner
  • Union, MO
National Provider Identifier
1275349003
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2025036567 Issued in MO
Practice address
39 Silo Dr
Union, MO 63084-4917
Phone
(636) 234-3022
Fax
(636) 234-3023
NPI assigned
Dec 6, 2024
Last updated
Nov 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2025036567 MO Primary

Addresses

Primary practice location

39 Silo Dr
Union, MO 63084-4917

Mailing address

39 Silo Dr
Union, MO 63084-4917
Phone (636) 234-3022

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
I20251203003719 MO Practitioner - Nurse Practitioner 1052804424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Saint Louis University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy East Ambulatory Services LLCGroup PAC ID 2365739240, 102 clinicians

Practice addresses (Care Compare)

39 Silo Dr
Union, MO 63084-4917
Phone (636) 234-3022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025036567MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy East Ambulatory Services LLC CurrentSince Nov 2, 2025 Accepting new patients

Locations

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

39 Silo Dr
Union, MO 63084
Phone (636) 234-3022

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

Organizations & group practices 1

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": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1275349003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 SILO DR",
            "city": "UNION",
            "state": "MO",
            "postal_code": "630844917",
            "telephone_number": "636-234-3022",
            "fax_number": "636-234-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 SILO DR",
            "city": "UNION",
            "state": "MO",
            "postal_code": "630844917",
            "telephone_number": "636-234-3022",
            "fax_number": "636-234-3023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVENUTO",
        "first_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025036567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, MO

Sources for this page

Verify at the official NPI Registry.