Individual provider Active NPI

Sue E Jagler, MD

  • Pediatrics Physician
  • Fenton, MO
National Provider Identifier
1508970872
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R9E06 Issued in MO
Practice address
714 Gravois Rd
Ste 200
Fenton, MO 63026-7723
Phone
(636) 349-5437
Fax
(636) 349-6663
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R9E06 MO Primary

Addresses

Primary practice location

714 Gravois Rd
Ste 200
Fenton, MO 63026-7723

Mailing address

714 Gravois Rd
Ste 200
Fenton, MO 63026-7723
Phone (636) 349-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1508970872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 GRAVOIS RD",
            "address_2": "STE 200",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267723",
            "telephone_number": "636-349-5437",
            "fax_number": "636-349-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 GRAVOIS RD",
            "address_2": "STE 200",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267723",
            "telephone_number": "636-349-5437",
            "fax_number": "636-349-6663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGLER",
        "first_name": "SUE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "R9E06",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.