Active NPI
Takia Nunnelly
- Laboratory Management Specialist/Technologist
- Saint Louis, MO
National Provider Identifier
1629914387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Laboratory Management Specialist/Technologist
- License
- 5387696376TN
- Practice address
- 1927 S Compton Ave Apt 3
Saint Louis, MO 63104-1579 - Phone
- (314) 532-7975
- NPI assigned
- Apr 27, 2026
- 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 |
|---|---|---|---|---|
| Laboratory Management Specialist/Technologist | 246QL0900X | 5387696376TN | MO | Primary |
Addresses
Primary practice location
1927 S Compton Ave Apt 3
Saint Louis, MO 63104-1579
Mailing address
1927 S Compton Ave Apt 3
Saint Louis, MO 63104-1579
Phone (314) 532-7975
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5387696376TN | MO | MD | Laboratory Management Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777248000000",
"number": "1629914387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1927 S COMPTON AVE APT 3",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041579",
"telephone_number": "314-532-7975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1927 S COMPTON AVE APT 3",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041579",
"telephone_number": "314-532-7975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUNNELLY",
"first_name": "TAKIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-04-27",
"last_updated": "2026-04-27",
"certification_date": "2026-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "246QL0900X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Laboratory Management",
"state": "MO",
"license": "5387696376TN",
"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 Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.