Individual provider Active NPI

Tammy L. Prewitt, F.N.P.

  • Family Nurse Practitioner
  • Eureka, MO
National Provider Identifier
1831283894
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
131584 Issued in MO
Practice address
20 The Legends Pkwy
Eureka, MO 63025-3801
Phone
(636) 938-3399
Fax
(636) 938-9609
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 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 131584 MO Primary

Addresses

Primary practice location

20 The Legends Pkwy
Eureka, MO 63025-3801

Mailing address

20 The Legends Pkwy
Eureka, MO 63025-3801
Phone (636) 938-3399

Other identifiers 1

IdentifierTypeStateIssuer
1831283894MedicaidMO

Other names 1

  • Tammy Simers Former name

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
I20101013000845 MO Practitioner - Nurse Practitioner 9931391620 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, shared by 6 NPIs, 573 clinicians

Practice addresses (Care Compare)

20 The Legends Pkwy
Eureka, MO 63025-3823
Phone (636) 938-3399

621 S New Ballas Rd
Suite 189a
Saint Louis, MO 63141-8255
Phone (314) 251-6335

621 S New Ballas Rd
Suite 4017B
Saint Louis, MO 63141-8269
Phone (314) 872-9192

Hospital & facility affiliations

  • Mercy Hospital Washington Hospital, Washington, MO, CCN 260052
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
131584MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Sep 7, 2010 Accepting new patients
Mercy Clinic East Communities CurrentSince Sep 7, 2010 Accepting new patients
Mercy Clinic East Communities Family Current Accepting new patients

Locations

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Interoperability endpoints

  • Direct secure messaging: tsimers1112@directc.mercy.net

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1831283894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 THE LEGENDS PKWY",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630253801",
            "telephone_number": "636-938-3399",
            "fax_number": "636-938-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 THE LEGENDS PKWY",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630253801",
            "telephone_number": "636-938-3399",
            "fax_number": "636-938-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREWITT",
        "first_name": "TAMMY",
        "middle_name": "L.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "131584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831283894",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMY",
            "last_name": "SIMERS",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eureka, MO

Sources for this page

Verify at the official NPI Registry.