Individual provider Active NPI

Rebecca Ruth Schneider, PA-C

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1568090769
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2020007081 Issued in MO
Practice address
607 S New Ballas Rd Ste 2350
Saint Louis, MO 63141-0001
Phone
(314) 251-4260
NPI assigned
Apr 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085007387 IL
Physician Assistant 363A00000X 2020007081 MO Primary

Addresses

Primary practice location

607 S New Ballas Rd Ste 2350
Saint Louis, MO 63141-0001

Mailing address

636 Wild Horse Creek Dr
Fairview Heights, IL 62208-2049
Phone (618) 319-2432

Other practice location 1

10050 Kennerly Rd Ste 2500
Saint Louis, MO 63128-2106
Phone (314) 251-4260

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
I20200910001973 MO Practitioner - Physician Assistant 3870911670 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085007387ILMDPhysician Assistant
2020007081MOMDPhysician Assistant

Organizations & group practices 1

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1568090769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 WILD HORSE CREEK DR",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082049",
            "telephone_number": "618-319-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 S NEW BALLAS RD STE 2350",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631410001",
            "telephone_number": "314-251-4260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10050 Kennerly Rd Ste 2500",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282106",
            "country_code": "US",
            "telephone_number": "314-251-4260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "REBECCA",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007387",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2020007081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.