Individual provider Active NPI

Tabitha Kennedy Sleeper, APRN,MSN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Peters, MO
National Provider Identifier
1285596957
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2025050092 Issued in MO
Practice address
540 Legacy Pointe Dr
Saint Peters, MO 63376-2263
Phone
(314) 484-4433
NPI assigned
Dec 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2025050092 MO Primary

Addresses

Primary practice location

540 Legacy Pointe Dr
Saint Peters, MO 63376-2263

Mailing address

540 Legacy Pointe Dr
Saint Peters, MO 63376-2263
Phone (314) 484-4433

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
I20260130000191 MO Practitioner - Nurse Practitioner 5890273981 Reassigns benefits to 1 organization
I20260511000205 IL Practitioner - Nurse Practitioner 5890273981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2311 Kingstowne Way CT
Wildwood, MO 63011-1891

3636 S Geyer Rd
Suite 100
Saint Louis, MO 63127-1237

4121 Union Rd
Suite 201
Saint Louis, MO 63129-1070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
2025050092MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Behavioral Health, LLC CurrentSince Dec 29, 2025 Accepting new patients

Locations

852 Cambridge Blvd
Ste 300
O Fallon, IL 62269

4121 Union Rd
Ste 201
Saint Louis, MO 63129
Phone (314) 930-3520

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1764547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1285596957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 LEGACY POINTE DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762263",
            "telephone_number": "314-484-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 LEGACY POINTE DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762263",
            "telephone_number": "314-484-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY SLEEPER",
        "first_name": "TABITHA",
        "credential": "APRN,MSN, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-01",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2025050092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.