Individual provider Active NPI

Lesly J Czajkowski, RN, BSN, FNP-BC

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1669956512
Registry record updated Sep 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016024881 Issued in MO
Practice address
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone
(314) 996-5000
NPI assigned
Sep 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2018

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 2016024881 MO Primary

Addresses

Primary practice location

3015 N Ballas Rd
Saint Louis, MO 63131-2329

Mailing address

10 Royallprairie CT
O Fallon, MO 63368-6984
Phone (636) 240-0069

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
I20221031001436 MO Order and Referring Only - Nurse Practitioner 4486021748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537142400000",
    "number": "1669956512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 ROYALLPRAIRIE CT",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686984",
            "telephone_number": "636-240-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZAJKOWSKI",
        "first_name": "LESLY",
        "middle_name": "J",
        "credential": "RN, BSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-17",
        "last_updated": "2018-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016024881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.