Individual provider Active NPI

Janet M Pitlyk, PNP

  • Pediatric Nurse Practitioner
  • St. Charles, MO
National Provider Identifier
1669516696
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN081404 Issued in MO
Practice address
2740 Highway 94 South
Suite a
St. Charles, MO 63303
Phone
(636) 936-0497
Fax
(636) 441-4398
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN081404 MO Primary

Addresses

Primary practice location

2740 Highway 94 South
Suite a
St. Charles, MO 63303

Mailing address

446 Foote Ave
Saint Louis, MO 63119-1503
Phone (314) 968-3774

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN081404MOMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: jpitlyk230@directc.mercy.net

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669516696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 FOOTE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631191503",
            "telephone_number": "314-968-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 HIGHWAY 94 SOUTH",
            "address_2": "SUITE A",
            "city": "ST. CHARLES",
            "state": "MO",
            "postal_code": "63303",
            "telephone_number": "636-936-0497",
            "fax_number": "636-441-4398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITLYK",
        "first_name": "JANET",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "RN081404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.