Individual provider Active NPI

Lyn Eve Vargo, PHD, RN, NNP-BC10/22

  • Neonatal Intensive Care Registered Nurse
  • Saint Louis, MO
National Provider Identifier
1396901013
Registry record updated Aug 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Intensive Care Registered NurseTaxonomy code 163WN0002X
License
064708 Issued in MO
Practice address
621 S New Ballas Rd
Suite 2016
Saint Louis, MO 63141-8232
Phone
(314) 251-5860
Fax
(314) 251-5861
NPI assigned
Aug 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 064708 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd
Suite 2016
Saint Louis, MO 63141-8232

Mailing address

31 Oak Bluff Dr
Lake Saint Louis, MO 63367-1801
Phone (636) 887-2020

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)
Not enrolled
Credentials
Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
064708MOMDNeonatal Intensive Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1396901013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 OAK BLUFF DR",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633671801",
            "telephone_number": "636-887-2020",
            "fax_number": "636-887-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 2016",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-5860",
            "fax_number": "314-251-5861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGO",
        "first_name": "LYN",
        "middle_name": "EVE",
        "name_prefix": "Dr.",
        "credential": "PHD, RN, NNP-BC10/22",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-01",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "MO",
            "license": "064708",
            "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 Aug 1, 2008; 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.