Individual provider Active NPI

Mareesha Ante Carter, FNP-C

  • Family Nurse Practitioner
  • Ballwin, MO
National Provider Identifier
1285463133
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2024029585 Issued in MO
Practice address
13861 Manchester Rd
Ballwin, MO 63011-4503
Phone
(314) 482-7547
NPI assigned
Jul 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 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 2024029585 MO Primary

Addresses

Primary practice location

13861 Manchester Rd
Ballwin, MO 63011-4503

Mailing address

13861 Manchester Rd
Ballwin, MO 63011-4503
Phone (636) 556-0114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240826003287 MO Practitioner - Nurse Practitioner 7517406200 Reassigns benefits to 1 organization
I20240911000115 IL Practitioner - Nurse Practitioner 7517406200 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chestnut Health of Illinois LLCGroup PAC ID 2264747344, 38 clinicians

Practice addresses (Care Compare)

1530 N Randall Rd
Suite 210
Elgin, IL 60123-7879
Phone (224) 760-7322

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Granite City Urgent Care Walk-in Clinic CurrentSince Dec 28, 2025 Accepting new patients
Waterloo Urgent Care Walk in Clinic Company CurrentSince Dec 28, 2025 Accepting new patients
Chestnut Health of Illinois LLC CurrentSince Feb 6, 2025 Accepting new patients
Total Access Urgent Care, PC CurrentSince Aug 2, 2024 Accepting new patients
Tauc Il, PC CurrentSince Aug 28, 2024 Accepting new patients
Belleville Urgent Care Walk-in Clinic CurrentSince Dec 28, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Sep 5, 2024 Accepting new patients
Wood River Urgent Care and Walk in Clinic Inc CurrentSince Dec 28, 2025 Accepting new patients
Total Access Urgent Care, PC CurrentSince Aug 2, 2024 Accepting new patients
Alton Urgent Care Walk in Clinic Company CurrentSince Dec 28, 2025 Accepting new patients

Locations

1417 Washington Ave
Alton, IL 62002
Phone (618) 260-0320

2801 W Main St
Belleville, IL 62226
Phone (618) 234-3053

404 Belt Line Rd
Collinsville, IL 62234
Phone (618) 215-5703

1530 N Randall Rd
Ste 210
Elgin, IL 60123
Phone (224) 760-7322

2861 Madison Ave
Granite City, IL 62040
Phone (618) 709-7723

1103 Central Park Dr
O Fallon, IL 62269
Phone (618) 215-5703

907 N Illinois Route 3
Waterloo, IL 62298
Phone (618) 350-0200

211 Madison Ave
Wood River, IL 62095
Phone (618) 709-7723

14671 Telegraph Rd
Redford, MI 48239
Phone (313) 387-2100

9556 Manchester Rd
Saint Louis, MO 63119
Phone (314) 373-5740

1717 Madison Ave
Washington, MO 63090
Phone (636) 244-6950

13861 Manchester Rd
Wildwood, MO 63011
Phone (636) 220-9333

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 10

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": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1285463133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13861 MANCHESTER RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114503",
            "telephone_number": "636-556-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13861 MANCHESTER RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114503",
            "telephone_number": "314-482-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "MAREESHA",
        "middle_name": "ANTE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2024029585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

Verify at the official NPI Registry.