Individual provider Active NPI

Kimberly Manning, ANP

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1306252457
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2014015458 Issued in MO
Practice address
2900 Lemay Ferry Rd
Ste 104
Saint Louis, MO 63125-3900
Phone
(314) 525-1887
Fax
(314) 525-1868
NPI assigned
Jul 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2014015458 MO Primary

Addresses

Primary practice location

2900 Lemay Ferry Rd
Ste 104
Saint Louis, MO 63125-3900

Mailing address

2900 Lemay Ferry Rd
Ste 104
Saint Louis, MO 63125-3900
Phone (314) 525-1887

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
I20140916001673 MO Practitioner - Nurse Practitioner 6608095138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

3637 S Geyer Rd
Saint Louis, MO 63127-1203
Phone (314) 251-4659

621 S New Ballas Rd
Suite 4017B
Saint Louis, MO 63141-8269
Phone (314) 872-9192

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Jan 1, 2020 Accepting new patients
Mercy Clinic East Communities CurrentSince Jan 1, 2020 Accepting new patients

Locations

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

5425 Southfield Ctr
Saint Louis, MO 63123
Phone (314) 543-5258

12700 Southfork Rd
Ste 105
Saint Louis, MO 63128
Phone (314) 525-1887

Organizations & group practices 2

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": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1306252457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 LEMAY FERRY RD",
            "address_2": "STE 104",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631253900",
            "telephone_number": "314-525-1887",
            "fax_number": "314-525-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 LEMAY FERRY RD",
            "address_2": "STE 104",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631253900",
            "telephone_number": "314-525-1887",
            "fax_number": "314-525-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2014015458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.