Individual provider Active NPI

Julia Slavik

  • Gerontology Nurse Practitioner
  • O Fallon, MO
National Provider Identifier
1477909166
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
298295 Issued in AZ
Practice address
7068 S Outer 364
O Fallon, MO 63368-7757
Phone
(636) 240-6100
NPI assigned
May 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Clinical Nurse Specialist 364SG0600X 2016003746 MO
Adult Health Clinical Nurse Specialist 364SA2200X 2016003746 MO
Gerontology Nurse Practitioner 363LG0600X 298295 AZ Primary

Addresses

Primary practice location

7068 S Outer 364
O Fallon, MO 63368-7757

Mailing address

4542 Ferrer Dr
Saint Louis, MO 63129-3741
Phone (314) 703-3918

Other practice location 1

2030 W Baseline Rd # 182-5671
Phoenix, AZ 85041-6574
Phone (855) 386-2799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201231000576 MO Practitioner - Certified Clinical Nurse Specialist (CNS) 2567875032 Reassigns benefits to 1 organization
I20241216003827 AZ Practitioner - Nurse Practitioner 2567875032 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016003746MOMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Cardiovascular LLC CurrentSince Dec 1, 2024 Accepting new patients
Elite Pain and Spine Institute, PLC PastSince Dec 1, 2024 Accepting new patients
Cardiac Care Alliance Network of Arizona LLC PastSince Oct 22, 2023 Accepting new patients

Locations

9191 W Thunderbird Rd
Ste D105
Peoria, AZ 85381
Phone (623) 849-3811

13943 N 91st Ave
Ste A101
Peoria, AZ 85381
Phone (480) 900-7373

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1477909166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4542 FERRER DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631293741",
            "telephone_number": "314-703-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7068 S OUTER 364",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687757",
            "telephone_number": "636-240-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2030 W Baseline Rd # 182-5671",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850416574",
            "country_code": "US",
            "telephone_number": "855-386-2799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLAVIK",
        "first_name": "JULIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "MO",
            "license": "2016003746",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "MO",
            "license": "2016003746",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "298295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

Verify at the official NPI Registry.