Individual provider Active NPI

Agnes Elisabeth Bayer, CPNP

  • Pediatric Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1831390772
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
2018011775 Issued in MO
Practice address
7387 Watson Rd
Saint Louis, MO 63119
Phone
(314) 500-5437
Fax
(314) 500-5683
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2018040896 MO
Registered Nurse 163W00000X 479405-1 NY
Nurse Practitioner 363L00000X 706774 TX
Pediatric Nurse Practitioner 363LP0200X F381465 NY
Pediatric Nurse Practitioner 363LP0200X AP124482 TX
Pediatric Nurse Practitioner 363LP0200X 2018011775 MO Primary

Addresses

Primary practice location

7387 Watson Rd
Saint Louis, MO 63119

Mailing address

7387 Watson Rd
Saint Louis, MO 63119-4405
Phone (314) 500-5437

Other practice location 1

2401 S 31st St
Temple, TX 76508-0001
Phone (254) 724-2111

Other identifiers 1

IdentifierTypeStateIssuer
01976989MedicaidNY

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
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2018040896MOMDRegistered Nurse
479405-1NYMDRegistered Nurse
706774TXMDNurse Practitioner
2018011775MOMDPediatric Nurse Practitioner
F381465NYMDPediatric Nurse Practitioner
AP124482TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Gianna Pediatrics, LLC Past Accepting new patients

Organizations & group practices 1

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1831390772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7387 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631194405",
            "telephone_number": "314-500-5437",
            "fax_number": "314-500-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7387 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63119",
            "telephone_number": "314-500-5437",
            "fax_number": "314-500-5683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAYER",
        "first_name": "AGNES",
        "middle_name": "ELISABETH",
        "name_prefix": "Ms.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2018040896",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "479405-1",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "706774",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F381465",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP124482",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2018011775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01976989",
            "state": "NY"
        }
    ],
    "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 Jan 22, 2019; 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.