Individual provider Active NPI

Denise L. Spear, RN, WHNP-BC

  • Women's Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1548411671
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
2002011429 Issued in MO
Practice address
4000 Jennings Station Rd
Saint Louis, MO 63121-3323
Phone
(314) 679-7909
NPI assigned
Oct 7, 2008
Last updated
Oct 7, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 2002011429 MO Primary

Addresses

Primary practice location

4000 Jennings Station Rd
Saint Louis, MO 63121-3323

Mailing address

4000 Jennings Station Rd
Saint Louis, MO 63121-3323
Phone (314) 679-7909

Other identifiers 1

IdentifierTypeStateIssuer
424446805MedicaidMO

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
I20081020000130 MO Practitioner - Nurse Practitioner 1254499304 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of St Louis Division of Fiscal Management CurrentSince Oct 9, 2008 Accepting new patients
County of St Louis Division of Fiscal Management CurrentSince Oct 9, 2008 Accepting new patients

Locations

4000 Jennings Station Rd
Saint Louis, MO 63121
Phone (314) 679-7800

4000 Jennings Station Rd
#4000
Saint Louis, MO 63121

6121 N Hanley Rd
Saint Louis, MO 63134
Phone (314) 522-6410

6121 N Hanley Rd
#C
Saint Louis, MO 63134
Phone (314) 615-0500

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1548411671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 JENNINGS STATION RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631213323",
            "telephone_number": "314-679-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 JENNINGS STATION RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631213323",
            "telephone_number": "314-679-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEAR",
        "first_name": "DENISE",
        "middle_name": "L.",
        "credential": "RN, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MO",
            "license": "2002011429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424446805",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.