Active NPI
Laura Lea Raineri, FNP
- Family Nurse Practitioner
- Scott Afb, IL
National Provider Identifier
1578029419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2019005030
- Practice address
- 310 W Losey St
Scott Afb, IL 62225-5250 - Phone
- (618) 250-8425
- Fax
- (618) 256-6133
- NPI assigned
- Feb 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | |||
| Family Nurse Practitioner | 363LF0000X | 2019005030 | MO | Primary |
Addresses
Primary practice location
310 W Losey St
Scott Afb, IL 62225-5250
Mailing address
1254 Main St
Imperial, MO 63052-3861
Phone (636) 741-3130
Other practice location 1
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 678-2096
Other practice location 2
1254 Main St
Imperial, MO 63052
Phone (636) 741-3130
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019005030 | MO | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647820800000",
"number": "1578029419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1254 MAIN ST",
"city": "IMPERIAL",
"state": "MO",
"postal_code": "630523861",
"telephone_number": "636-741-3130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 W LOSEY ST",
"city": "SCOTT AFB",
"state": "IL",
"postal_code": "622255250",
"telephone_number": "618-250-8425",
"fax_number": "618-256-6133"
}
],
"practiceLocations": [
{
"address_1": "1465 S Grand Blvd",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631041003",
"country_code": "US",
"telephone_number": "314-678-2096",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1254 Main St",
"address_purpose": "LOCATION",
"city": "Imperial",
"state": "MO",
"postal_code": "63052",
"country_code": "US",
"telephone_number": "636-741-3130",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RAINERI",
"first_name": "LAURA",
"middle_name": "LEA",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-15",
"last_updated": "2022-03-21",
"certification_date": "2022-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2019005030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scott Afb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.