Individual provider Active NPI

Marsha Faye Luster-Smith, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1396083002
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2012036462 Issued in MO
Practice address
939 Gay Ave
Saint Louis, MO 63130-2737
Phone
(314) 721-3746
NPI assigned
Jan 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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 2012036462 MO Primary

Addresses

Primary practice location

939 Gay Ave
Saint Louis, MO 63130-2737

Mailing address

939 Gay Ave
Saint Louis, MO 63130-2737
Phone (314) 721-3746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012036462MOMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1396083002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 GAY AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631302737",
            "telephone_number": "314-721-3746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 GAY AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631302737",
            "telephone_number": "314-721-3746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTER-SMITH",
        "first_name": "MARSHA",
        "middle_name": "FAYE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-30",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012036462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.