Active NPI
Alicia Renee Fields, D.D.S.
- Dentist
- Saint Louis, MO
National Provider Identifier
1689835027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2008016064
- Practice address
- 777 S New Ballas Rd
Ste. 323W
Saint Louis, MO 63141-8705 - Phone
- (314) 567-7372
- Fax
- (314) 567-7372
- NPI assigned
- Jun 18, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2008016064 | MO | Primary |
Addresses
Primary practice location
777 S New Ballas Rd
Ste. 323W
Saint Louis, MO 63141-8705
Mailing address
146 Homeshire Dr
Wentzville, MO 63385-4862
Phone (816) 830-7623
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151231001366 | MO | Order and Referring Only - Dentist | 0547562985 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213747200000",
"number": "1689835027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "146 HOMESHIRE DR",
"city": "WENTZVILLE",
"state": "MO",
"postal_code": "633854862",
"telephone_number": "816-830-7623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 S NEW BALLAS RD",
"address_2": "STE. 323W",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418705",
"telephone_number": "314-567-7372",
"fax_number": "314-567-7372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIELDS",
"first_name": "ALICIA",
"middle_name": "RENEE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-18",
"last_updated": "2008-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2008016064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jun 18, 2008; 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.