Pamela Vantrice Royston, MO HEALTH NET PROVID

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Practice address

11581 W Florissant Ave
Florissant, MO 63033-6740

Phone

(314) 664-5155

Fax

(866) 255-9006

NPI assigned

Dec 28, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Pamela Vantrice Greer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1649742842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11581 W FLORISSANT AVE",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336740",
            "telephone_number": "314-664-5155",
            "fax_number": "866-255-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11581 W FLORISSANT AVE",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336740",
            "telephone_number": "314-664-5155",
            "fax_number": "866-255-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYSTON",
        "first_name": "PAMELA",
        "middle_name": "VANTRICE",
        "name_prefix": "Mrs.",
        "credential": "MO HEALTH NET PROVID",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-28",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "GREER",
            "middle_name": "VANTRICE",
            "prefix": "MISS",
            "credential": "HCBS PROVIDER SINCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Adult Day Care Clinic/Center in Florissant, MO
• Providers in Florissant, MO by specialty
• Adult Day Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.