Active NPI
Patrice Lynn Wakefield, M.D.
- General Practice Physician
- Saint Louis, MO
National Provider Identifier
1558538850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 34692
- Practice address
- 514 Donne Ave
Saint Louis, MO 63130-3918 - Phone
- (314) 721-7329
- Fax
- (314) 725-2319
- NPI assigned
- May 15, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 34692 | MO | Primary |
Addresses
Primary practice location
514 Donne Ave
Saint Louis, MO 63130-3918
Mailing address
514 Donne Ave
Saint Louis, MO 63130-3918
Phone (314) 721-7329
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34692 | MO | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210809600000",
"number": "1558538850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "514 DONNE AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631303918",
"telephone_number": "314-721-7329",
"fax_number": "314-725-2319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "514 DONNE AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631303918",
"telephone_number": "314-721-7329",
"fax_number": "314-725-2319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAKEFIELD",
"first_name": "PATRICE",
"middle_name": "LYNN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-15",
"last_updated": "2008-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MO",
"license": "34692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
- Karen Marie Wait, OTR/L
- Matthew Daniel Waite, DDS, MPH, MSD
- Robert Waite, CRNA
- Stuart D Waite, DDS, MBA
- Candace Therese Wakefield, D.M.D
- Willow Wakeley-Smith, LMSW
- Cynthia Wakil, MD
- Wal-Mart Stores East LP (Walmart Pharmacy 10-3061)
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2213)
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1265)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.