Active NPI
Teresa T Dillard, PNP
- Nurse Practitioner
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 124737
- Practice address
- 3844 S Lindbergh Blvd
Ste 216
Saint Louis, MO 63127-1416 - Phone
- (314) 525-0580
- Fax
- (314) 525-0581
- NPI assigned
- Aug 4, 2008
- Last updated
- Apr 17, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 124737 | MO | Primary |
Addresses
Primary practice location
3844 S Lindbergh Blvd
Ste 216
Saint Louis, MO 63127-1416
Mailing address
PO Box 7412049
Chicago, IL 60674-2049
Phone (314) 525-0580
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 429048309 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124737 | MO | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arch Pediatrics LLC | Current | Accepting new patients | |
| Mercy Clinic East Communities | Current | Accepting new patients | |
| Mercy Hospitals East Communities | Current | Accepting new patients | |
| Mercy Hospitals East Communities | Current | Accepting new patients |
Locations
3844 S Lindbergh Blvd
Ste 216
Saint Louis, MO 63127
Phone (314) 525-0580
615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687
621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192
Interoperability endpoints
- tdillard100161@directc.mercy.net
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.
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1275014953
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1851335228
-
dba Mercy St. Louis Transport Ambulance
- Land Ambulance
- Saint Louis, MO
- NPI 1881329902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744848000000",
"number": "1689830168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7412049",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606742049",
"telephone_number": "314-525-0580",
"fax_number": "314-525-0581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3844 S LINDBERGH BLVD",
"address_2": "STE 216",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631271416",
"telephone_number": "314-525-0580",
"fax_number": "314-525-0581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLARD",
"first_name": "TERESA",
"middle_name": "T",
"name_prefix": "Mrs.",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-04",
"last_updated": "2025-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MO",
"license": "124737",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "429048309",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "3844 S Lindbergh Blvd",
"address_2": "Ste 216",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631271416",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.