Individual provider Active NPI

Becky J. Ganz, ANP

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1922208024
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
149360 Issued in MO
Practice address
4921 Parkview PL
7TH Floor
Saint Louis, MO 63110-1032
Phone
(314) 747-1171
Fax
(314) 362-3192
NPI assigned
Jul 18, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CJW Enterprises, Inc 5 clinicians

Practice addresses (Care Compare)

522 N New Ballas Rd
Suite 199
Saint Louis, MO 63141-6815
Phone (314) 434-1600

9915 Kennerly Rd
Saint Louis, MO 63128-2703

9915 Kennerly Rd J
Saint Louis, MO 63128-2703
Phone (314) 843-4794

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
I20070828001128 MO Practitioner - Nurse Practitioner 8325130891 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: beckyganz@ihadv.allscriptsdirect.net

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 149360 MO Primary

Addresses

NPPES NPI Registry

Primary practice location

4921 Parkview PL
7TH Floor
Saint Louis, MO 63110-1032

Mailing address

660 S Euclid Ave
C B 8056
Saint Louis, MO 63110-1010
Phone (314) 747-1171

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
426315602MedicaidMO

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 23, 2009.

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232668800000",
    "number": "1922208024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "C B 8056",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-747-1171",
            "fax_number": "314-362-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "address_2": "7TH FLOOR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-747-1171",
            "fax_number": "314-362-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANZ",
        "first_name": "BECKY",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2009-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "149360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "426315602",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.