Individual provider Active NPI

Elizabeth A Brady-Clymer, RN

  • Registered Nurse
  • Saint Louis, MO
National Provider Identifier
1578870580
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
2007011054 Issued in MO
Practice address
2639 Miami St FL 4
Saint Louis, MO 63118-3929
Phone
(314) 361-1630
Fax
(314) 361-3302
NPI assigned
Sep 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2007011054 MO Primary

Addresses

Primary practice location

2639 Miami St FL 4
Saint Louis, MO 63118-3929

Mailing address

900 E Laharpe St
Kirksville, MO 63501-4520
Phone (660) 665-1962

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2007011054MOMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284336000000",
    "number": "1578870580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E LAHARPE ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014520",
            "telephone_number": "660-665-1962",
            "fax_number": "660-665-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 MIAMI ST FL 4",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183929",
            "telephone_number": "314-361-1630",
            "fax_number": "314-361-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY-CLYMER",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-13",
        "last_updated": "2010-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2007011054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; 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.