Monet Beatty
Individual provider Active NPI Prosthetics Case Management · Saint Louis, MO
NPI 1629460845 · NPPES record last updated Feb 25, 2015
Key facts
- NPI
- 1629460845
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Prosthetics Case Management 1744P3200X
- License
- 2011036013 (MO)
- Practice address
- 9206 Lackland Rd
Saint Louis, MO 63114-5413 - Phone
- (314) 600-7055
- NPI assigned
- Feb 25, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011036013 | MO | MD | Prosthetics Case Management |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | 2011036013 | MO | Yes |
Addresses
Primary practice location
9206 Lackland Rd
Saint Louis, MO 63114-5413
Mailing address
9206 Lackland Rd
Saint Louis, MO 63114-5413
Phone (314) 600-7055
NPI Registry JSON
{
"created_epoch": "1424822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424822400000",
"number": "1629460845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9206 LACKLAND RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631145413",
"telephone_number": "314-600-7055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9206 LACKLAND RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631145413",
"telephone_number": "314-600-7055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEATTY",
"first_name": "MONET",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-25",
"last_updated": "2015-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "MO",
"license": "2011036013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
- Mary Jo Beason
- Michael G Beat
- Elizabeth Beattie
- Adriena Cothron Beatty
- Kristen D Beatty
- Diana Kay Beaty
- Stacy Beaty
- Olivia Beaubrun
- Tatyana Beaubrun
- Jakeia Kiarra Beauford I
All providers in Saint Louis, MO · Prosthetics Case Management in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.