Nicholas Ronald Fadell

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

4545 Forest Park Ave Apt 313
Saint Louis, MO 63108-2172

Phone

(937) 701-3294

NPI assigned

Mar 5, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1709596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1851158992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 FOREST PARK AVE APT 313",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 FOREST PARK AVE APT 313",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082172",
            "telephone_number": "937-701-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADELL",
        "first_name": "NICHOLAS",
        "middle_name": "RONALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Elyse Facer, DO
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• Factor Physical Therapy
• Michael Faddis, DDS
• Mitchell N Faddis, MD
• Ruaa Mamoun Suliman Fadl, M.D.
• Karen Faerber, LPS
• Christina Marie Fagan, MSW,LCSW
• David B Fagan, M.D.
• Leonard F Fagan, M.D.

• Student in an Organized Health Care Education/Training Program in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Student in an Organized Health Care Education/Training Program in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.