Individual provider Active NPI

Gladys Waturi Gitau, CNP

  • Gerontology Nurse Practitioner
  • Saint Charles, MO
National Provider Identifier
1841855335
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
2019015944 Issued in MO
Practice address
300 1St Capitol Dr
Saint Charles, MO 63301-2844
Phone
(636) 947-5010
NPI assigned
May 9, 2019
Last updated
Aug 31, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 2019015944 MO Primary

Addresses

Primary practice location

300 1St Capitol Dr
Saint Charles, MO 63301-2844

Mailing address

PO Box 776874
Chicago, IL 60677-6874
Phone (314) 291-7997

Other practice location 1

12774 Boenker Ln
Bridgeton, MO 63044-2436
Phone (314) 291-7997

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
I20190905002911 MO Practitioner - Nurse Practitioner 8527397256 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Physician Group Missouri LLCGroup PAC ID 4082958574, 18 clinicians

Practice addresses (Care Compare)

12380 Depaul Dr
Bridgeton, MO 63044-2511
Phone (314) 447-9700

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-6500

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bimla Dhan LLC Single Specialty CurrentSince Dec 27, 2024 Accepting new patients
Northwest Infectious Disease Services LLC Single Specialty CurrentSince Sep 1, 2019 Accepting new patients
St Anthonys Physician Organization Hospitalist Services, L.C. Single Specialty CurrentSince Sep 3, 2019 Accepting new patients
In Charge Medical Professionals LLC Single Specialty Past Accepting new patients

Locations

12380 De Paul Dr
Bridgeton, MO 63044
Phone (314) 447-9700

12774 Boenker Ln
Bridgeton, MO 63044
Phone (314) 291-7997

3394 McKelvey Rd
Ste 115
Bridgeton, MO 63044
Phone (314) 643-7692

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1841855335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776874",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776874",
            "telephone_number": "314-291-7997",
            "fax_number": "314-739-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 1ST CAPITOL DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012844",
            "telephone_number": "636-947-5010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12774 Boenker Ln",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442436",
            "country_code": "US",
            "telephone_number": "314-291-7997",
            "fax_number": "314-739-1471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GITAU",
        "first_name": "GLADYS",
        "middle_name": "WATURI",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-09",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2019015944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.