Individual provider Active NPI

Lauren Poor, AGNP

  • Nurse Practitioner
  • Chesterfield, MO
National Provider Identifier
1477005734
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2018014129 Issued in MO
Practice address
14528 S Outer 40 Rd Ste 100
Chesterfield, MO 63017-5743
Phone
(314) 364-1440
Fax
(314) 362-5743
NPI assigned
Nov 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2018014129 MO Primary

Addresses

Primary practice location

14528 S Outer 40 Rd Ste 100
Chesterfield, MO 63017-5743

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (314) 364-1440

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
I20180926001579 MO Practitioner - Nurse Practitioner 7911258223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

3915 Watson Rd
Saint Louis, MO 63109-1251
Phone (314) 800-2820

621 S New Ballas Rd
Suite 4017B
Saint Louis, MO 63141-8269
Phone (314) 872-9192

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018014129MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Sep 5, 2023 Accepting new patients

Locations

14528 South Outer 40 Rd
Ste 100
Chesterfield, MO 63017
Phone (314) 628-5627

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

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 1

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": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1477005734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "314-364-1440",
            "fax_number": "314-364-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14528 S OUTER 40 RD STE 100",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175743",
            "telephone_number": "314-364-1440",
            "fax_number": "314-362-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOR",
        "first_name": "LAUREN",
        "name_prefix": "Ms.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-02",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2018014129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.