Individual provider Active NPI

Nkiru Amailo Umekwe

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1952090235
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2025011409 Issued in MO
Practice address
401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone
(314) 678-2451
Fax
(314) 353-1310
NPI assigned
May 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2025011409 MO Primary

Addresses

Primary practice location

401 Holly Hills Ave
Saint Louis, MO 63111-2410

Mailing address

401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone (314) 678-2451

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
I20250701003111 MO Practitioner - Physician Assistant 5395258420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Health CentersGroup PAC ID 7911815097, 53 clinicians

Practice addresses (Care Compare)

401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone 31448116151306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2025011409MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Health Centers CurrentSince Jul 7, 2025 Accepting new patients

Locations

401 Holly Hills Ave
Saint Louis, MO 63111
Phone (314) 353-5190

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": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1952090235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HOLLY HILLS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631112410",
            "telephone_number": "314-678-2451",
            "fax_number": "314-353-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HOLLY HILLS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631112410",
            "telephone_number": "314-678-2451",
            "fax_number": "314-353-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMEKWE",
        "first_name": "NKIRU",
        "middle_name": "AMAILO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2025011409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.