Individual provider Active NPI

Anita Sue Wiggs, AGPCNP

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1497138614
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2015007609 Issued in MO
Practice address
8710 Manchester Rd
Saint Louis, MO 63144-2724
Phone
(314) 961-3570
Fax
(314) 961-6450
NPI assigned
Jul 7, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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 2015007609 MO Primary

Addresses

Primary practice location

8710 Manchester Rd
Saint Louis, MO 63144-2724

Mailing address

8710 Manchester Rd
Saint Louis, MO 63144-2724
Phone (314) 961-3570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015007609MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince Jul 13, 2015 Accepting new patients
Vpa PC CurrentSince Jul 13, 2015 Accepting new patients

Locations

8706 Manchester Rd
Ste 106
Saint Louis, MO 63144
Phone (314) 961-3570

8710 Manchester Rd
Saint Louis, MO 63144
Phone (314) 961-3570

Organizations & group practices 2

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": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1497138614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8710 MANCHESTER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631442724",
            "telephone_number": "314-961-3570",
            "fax_number": "314-961-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8710 MANCHESTER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631442724",
            "telephone_number": "314-961-3570",
            "fax_number": "314-961-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGS",
        "first_name": "ANITA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2015007609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.