Individual provider Active NPI

Kelli E Dean Riegel, PA-C

  • Physician Assistant
  • Chesterfield, MO
National Provider Identifier
1811295710
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2011005765 Issued in MO
Practice address
14825 N Outer 40 Rd
Suite 200
Chesterfield, MO 63017-2152
Phone
(314) 336-2555
Fax
(314) 336-2557
NPI assigned
Mar 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 2011005765 MO Primary

Addresses

Primary practice location

14825 N Outer 40 Rd
Suite 200
Chesterfield, MO 63017-2152

Mailing address

14825 N Outer 40 Rd
Suite 200
Chesterfield, MO 63017-2152
Phone (314) 336-2555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: kelli.dean.riegel.1@2394.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1811295710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14825 N OUTER 40 RD",
            "address_2": "SUITE 200",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172152",
            "telephone_number": "314-336-2555",
            "fax_number": "314-336-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14825 N OUTER 40 RD",
            "address_2": "SUITE 200",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172152",
            "telephone_number": "314-336-2555",
            "fax_number": "314-336-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN RIEGEL",
        "first_name": "KELLI",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-02",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2011005765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.