Individual provider Active NPI

Brook Raye

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1710252176
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2011041300 Issued in MO
Practice address
8571 Watson Rd
Saint Louis, MO 63119-5218
Phone
(866) 825-3227
NPI assigned
Mar 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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 2011041300 MO Primary

Addresses

Primary practice location

8571 Watson Rd
Saint Louis, MO 63119-5218

Mailing address

161 Washington St
Eight Tower Suite 1400
Conshohocken, PA 19428-2083

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
I20120529000344 MO Practitioner - Nurse Practitioner 3870756992 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Institute for Research and Education in Family MedicineGroup PAC ID 6608833587, 9 clinicians

Practice addresses (Care Compare)

9417 S Broadway
Saint Louis, MO 63125-2009
Phone (314) 833-4030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011041300MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group Inc. CurrentSince Aug 22, 2016 Accepting new patients
SSM Medical Group, Inc. CurrentSince Aug 22, 2016 Accepting new patients

Locations

917 Chesterfield Pkwy E
Chesterfield, MO 63017
Phone (314) 687-2719

920 N Main St
O Fallon, MO 63366
Phone (314) 687-2731

1551 Wall St
Ste 310
Saint Charles, MO 63303
Phone (636) 669-2268

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

8571 Watson Rd
Webster Grvs, MO 63119
Phone (314) 687-2715

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1710252176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 WASHINGTON ST",
            "address_2": "EIGHT TOWER SUITE 1400",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8571 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631195218",
            "telephone_number": "866-825-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYE",
        "first_name": "BROOK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2011041300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.