Mia Daveta, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2023004707 Issued in MO

Practice address

4905 Mexico Rd.
Ste 400
Saint Peters, MO 63376

Phone

(314) 590-3721

NPI assigned

Apr 21, 2023

Last updated

Apr 21, 2023By the provider in NPPES

Sex

Female

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Serenity Health LLCGroup PAC ID 3375920861, 22 clinicians

One Behavioral of MissouriGroup PAC ID 6204313364, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: serenityhealthllc.miadaveta@154693.advancedmd-direct.com

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.

• One Behavioral of Missouri

  dba One Behavioral

  • Psychiatry Physician
  • Saint Louis, MO
  • NPI 1144182916
  Medicare reassignment Care Compare group NPD
• Serenity Health LLC

  • Psychiatry Physician
  • Saint Peters, MO
  • NPI 1104569151
  Medicare reassignment Care Compare group NPD
• St. Louis Internal Medicine Inc

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1104856442
  NPD (past)

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1932896586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 MEXICO RD.",
            "address_2": "STE 400",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "63376",
            "telephone_number": "314-590-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 MEXICO RD.",
            "address_2": "STE 400",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "63376",
            "telephone_number": "314-590-3721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVETA",
        "first_name": "MIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2023004707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Charles Dale III, D.M.D.
• Lea Marie Damrell, OTR/L
• Amanda Daniels
• Margaret Dannevik, MS, BCBA, LBA
• Ahmad Daraghmeh, MD
• Rebecca Ann Davey, OTRL
• David a. Lipsitz, PH.D., Inc
• David Guilbeault DMD Mid Rivers Dental Group (Mid Rivers Dental Group)
• David M Ivey DDS PC
• Sasha Marie David

• Psychiatric/Mental Health Nurse Practitioner in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.