Individual provider Active NPI

Madeleine Grace Pearson, CNP

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1467285452
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2024033994 Issued in MO
Practice address
621 S New Ballas Rd Ste 460a
Saint Louis, MO 63141-8259
Phone
(314) 251-4330
NPI assigned
Aug 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2024033994 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd Ste 460a
Saint Louis, MO 63141-8259

Mailing address

2530 W 428TH Rd
East Prairie, MO 63845-8835
Phone (573) 683-0288

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
I20241029004367 MO Practitioner - Nurse Practitioner 0042743049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Endocrinology LLCGroup PAC ID 7416073531, 7 clinicians

Practice addresses (Care Compare)

621 S New Ballas Rd
Suite 281a
Saint Louis, MO 63141-8256
Phone (314) 801-5292

621 S New Ballas Rd
Suite 460a
Saint Louis, MO 63141-8259
Phone (314) 251-4330

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Endocrinology, LLC CurrentSince Oct 28, 2024 Accepting new patients

Locations

621 S New Ballas Rd
Ste 460A
Saint Louis, MO 63141
Phone (314) 251-4330

621 S New Ballas Rd
Ste 281A
Saint Louis, MO 63141
Phone (314) 251-4772

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.

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": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1467285452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 W 428TH RD",
            "city": "EAST PRAIRIE",
            "state": "MO",
            "postal_code": "638458835",
            "telephone_number": "573-683-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 460A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418259",
            "telephone_number": "314-251-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "MADELEINE",
        "middle_name": "GRACE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2024033994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.