Individual provider Active NPI

Adina Diane Lumley Rey, FNP

  • Family Nurse Practitioner
  • Lake St Louis, MO
National Provider Identifier
1336558014
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2014020743 Issued in MO
Practice address
100 Medical PLZ
Lake St Louis, MO 63367-1366
Phone
(314) 317-0600
Fax
(314) 317-0606
NPI assigned
Aug 7, 2014
Last updated
Aug 7, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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 2014020743 MO Primary

Addresses

Primary practice location

100 Medical PLZ
Lake St Louis, MO 63367-1366

Mailing address

12101 Woodcrest Executive Dr
Suite 210
Saint Louis, MO 63141-5047
Phone (314) 317-0600

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
I20141030000549 MO Practitioner - Nurse Practitioner 2062633324 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5200 Executive Centre Pkwy
300 St. Peters Bone and Joint Surgery
Saint Peters, MO 63376-3394
Phone (636) 441-3444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014020743MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC CurrentSince Jul 1, 2016 Accepting new patients
St Peters Bone & Joint Surgery Inc. CurrentSince Jul 1, 2023 Accepting new patients
St Peters Bone & Joint Surgery Inc. CurrentSince Jul 1, 2023 Accepting new patients
SSM Medical Group, Inc. CurrentSince Aug 1, 2018 Accepting new patients

Locations

100 Medical Plz
Lake St Louis, MO 63367
Phone (636) 625-5200

4701 Highway K
O Fallon, MO 63368
Phone (636) 441-3444

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

5200 Executive Centre Pkwy
Ste 300
Saint Peters, MO 63376
Phone (636) 229-4222

172 Professional Pkwy
Troy, MO 63379
Phone (636) 462-6106

1603 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 332-8228

378 Shadow Pines Dr
Wentzville, MO 63385
Phone (636) 441-3444

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73033

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1336558014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12101 WOODCREST EXECUTIVE DR",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415047",
            "telephone_number": "314-317-0600",
            "fax_number": "314-317-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PLZ",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671366",
            "telephone_number": "314-317-0600",
            "fax_number": "314-317-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUMLEY REY",
        "first_name": "ADINA",
        "middle_name": "DIANE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2014020743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

Verify at the official NPI Registry.