Individual provider Active NPI

Andrea Desi Rae Bieser, RN

  • General Practice Registered Nurse
  • Saint Louis, MO
National Provider Identifier
1417445370
Registry record updated Apr 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
2015012879 Issued in MO
Practice address
1430 Olive St
Saint Louis, MO 63103-2360
Phone
(314) 645-6840
Fax
(314) 621-5006
NPI assigned
Apr 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WG0000X 2015012879 MO Primary

Addresses

Primary practice location

1430 Olive St
Saint Louis, MO 63103-2360

Mailing address

3258 5 Oaks Dr
Arnold, MO 63010-3883
Phone (573) 747-9039

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2015012879MOMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1417445370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3258 5 OAKS DR",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630103883",
            "telephone_number": "573-747-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 OLIVE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032360",
            "telephone_number": "314-645-6840",
            "fax_number": "314-621-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIESER",
        "first_name": "ANDREA",
        "middle_name": "DESI RAE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-26",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": "MO",
            "license": "2015012879",
            "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 Apr 26, 2018; 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.