Stacey Yvonne Pegues

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

Practice address

17081 North Outer 40 Rd Ste 117
Chesterfield, MO 63005-1452

Phone

(314) 496-0178

NPI assigned

May 31, 2023

Last updated

May 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fortieth & Vineyard Company LLC

  dba Wigs 2 Wellness

  • Prosthetics Case Management
  • Chesterfield, MO
  • NPI 1851071898
  NPD Authorized official

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1487347035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2369 WESFORD DR",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630434147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17081 NORTH OUTER 40 RD STE 117",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051452",
            "telephone_number": "314-496-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGUES",
        "first_name": "STACEY",
        "middle_name": "YVONNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pearle Vision Inc (Pearle Vision #C6673)
• Anthony C Pearlstone, MD
• Anthony C Pearson, MD
• Shilpa Peddi, MD
• Pediatric Neurodevelopmental Center LLC
• Mary Pellowski, O.T., C.H.T.
• John Henry Peloza, M.D.
• Pencil Kidz
• Marisa Pennington
• Lisa Ann Peoples, PT

• Prosthetics Case Management in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Prosthetics Case Management in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.