Individual provider Active NPI

Vita Rosenberg, FNP-C

  • Family Nurse Practitioner
  • Des Peres, MO
National Provider Identifier
1669158333
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023024690 Issued in MO
Practice address
1010 Old Des Peres Rd
Des Peres, MO 63131-1865
Phone
(314) 729-0077
Fax
(314) 729-0101
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2023024690 MO Primary

Addresses

Primary practice location

1010 Old Des Peres Rd
Des Peres, MO 63131-1865

Mailing address

PO Box 14369
Saint Louis, MO 63178-4369
Phone (314) 729-0077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230822002944 MO Practitioner - Nurse Practitioner 5092178186 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialized Wound Management LLCGroup PAC ID 4284628173, 3 clinicians
Minuteclinic Diagnostic of Kansas PAGroup PAC ID 7416043807, 139 clinicians

Practice addresses (Care Compare)

14805 N Outer 40 Rd
Suite 320
Chesterfield, MO 63017-6060
Phone (636) 536-0183

8021 Watson Rd
Webster Groves, MO 63119-5304
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Specialized Wound Management LLC CurrentSince Sep 1, 2023 Accepting new patients
Urology of St. Louis, Inc. PastSince Nov 12, 2023 Accepting new patients
Urology of St. Louis, Inc. Past Accepting new patients

Locations

14805 North Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 536-0183

14805 North Outer 40 Rd
Ste 320
Chesterfield, MO 63017
Phone (636) 536-0183

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1669158333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14369",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631784369",
            "telephone_number": "314-729-0077",
            "fax_number": "314-729-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 OLD DES PERES RD",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631311865",
            "telephone_number": "314-729-0077",
            "fax_number": "314-729-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "VITA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023024690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Peres, MO

Sources for this page

Verify at the official NPI Registry.