Individual provider Active NPI

Teresa Dumaine

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1356500300
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2019000531 Issued in MO
Practice address
9417 S Broadway
Saint Louis, MO 63125-2009
Phone
(314) 833-4030
Fax
(314) 833-4031
NPI assigned
Jun 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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 2019000531 MO Primary

Addresses

Primary practice location

9417 S Broadway
Saint Louis, MO 63125-2009

Mailing address

722 Loughborough Ave
Saint Louis, MO 63111-2732
Phone (314) 833-4030

Other names 1

  • Teresa McMurtry Former name

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
I20200430001327 MO Practitioner - Nurse Practitioner 3779913900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Institute for Research and Education in Family MedicineGroup PAC ID 6608833587, 9 clinicians

Practice addresses (Care Compare)

9417 S Broadway
Saint Louis, MO 63125-2009
Phone (314) 833-4030

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Research and Education in Family Medicine CurrentSince Mar 9, 2020 Accepting new patients

Locations (25 of 36)

3415 Bridgeland Dr
Bridgeton, MO 63044

11635 Oakbury Ct
Bridgeton, MO 63044
Phone (314) 213-8012

11280 Saint Charles Rock Rd
Bridgeton, MO 63044

11300 Saint Charles Rock Rd
Bridgeton, MO 63044
Phone (314) 739-6811

1700 Derhake Rd
Florissant, MO 63033
Phone (314) 989-7600

102 Fee Fee Rd
Maryland Heights, MO 63043
Phone (314) 213-8016

2497 Creve Coeur Mill Rd
Maryland Heights, MO 63043
Phone (314) 213-8051

3199 Parkwood Ln
Maryland Heights, MO 63043

195 Fee Fee Rd
Maryland Heights, MO 63043
Phone (314) 213-8033

2905 Rose Acres Ln
Maryland Heights, MO 63043
Phone (314) 213-8017

2900 Adie Rd
Saint Ann, MO 63074
Phone (314) 213-8100

3721 Saint Bridget Ln
Saint Ann, MO 63074
Phone (314) 213-8419

11055 Saint Charles Rock Rd
Saint Ann, MO 63074
Phone (314) 213-8032

529 Jefferson St
Saint Charles, MO 63301
Phone (636) 946-3771

9137 Old Bonhomme Rd
Saint Louis, MO 63132
Phone (314) 997-7002

818 Cass Ave
Saint Louis, MO 63106
Phone (314) 231-1147

5183 Raymond Ave
Saint Louis, MO 63113

7401 Florissant Rd
Saint Louis, MO 63121
Phone (314) 261-6011

3026 Laclede Ave
Saint Louis, MO 63103
Phone (314) 340-3366

5501 Delmar Blvd
Ste B560
Saint Louis, MO 63112

11022 Schuetz Rd
Saint Louis, MO 63146
Phone (314) 213-8018

4222 Delor St
Saint Louis, MO 63116
Phone (314) 773-6100

2727 N Kingshighway Blvd
Saint Louis, MO 63113
Phone (314) 450-7667

7520 Natural Bridge Rd
Saint Louis, MO 63121
Phone (314) 222-4877

3001 Meramec St
Saint Louis, MO 63118
Phone (314) 631-2470

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": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1356500300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 LOUGHBOROUGH AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631112732",
            "telephone_number": "314-833-4030",
            "fax_number": "314-833-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9417 S BROADWAY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631252009",
            "telephone_number": "314-833-4030",
            "fax_number": "314-833-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMAINE",
        "first_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019000531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "MCMURTRY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.