Individual provider Active NPI

Vanessa L Fitts, FNP-C

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1790146280
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016000968 Issued in MO
Practice address
12200 Weber Hill Rd Ste 100
Saint Louis, MO 63127-1599
Phone
(314) 698-2500
NPI assigned
Mar 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 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 2016000968 MO Primary

Addresses

Primary practice location

12200 Weber Hill Rd Ste 100
Saint Louis, MO 63127-1599

Mailing address

12200 Weber Hill Rd Ste 100
Saint Louis, MO 63127-1599
Phone (314) 698-2500

Other practice location 1

1101 E US Highway 54
Vandalia, MO 63382-2905
Phone (573) 594-6686 ext. 2699

Other identifiers 2

IdentifierTypeStateIssuer
1962488536MedicaidMO
1194849950MedicaidMO

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2016000968MOMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1790146280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 WEBER HILL RD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271599",
            "telephone_number": "314-698-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 WEBER HILL RD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271599",
            "telephone_number": "314-698-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 E US Highway 54",
            "address_purpose": "LOCATION",
            "city": "Vandalia",
            "state": "MO",
            "postal_code": "633822905",
            "country_code": "US",
            "telephone_number": "573-594-6686 x2699",
            "fax_number": "573-594-6680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITTS",
        "first_name": "VANESSA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-11",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016000968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962488536",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194849950",
            "state": "MO"
        }
    ],
    "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 Mar 30, 2018; 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.