Michelle R De Vera, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

102273 Issued in MO

Practice address

8888 Ladue Rd Ste 220
Saint Louis, MO 63124-2056

Phone

(314) 644-3336

Fax

(314) 644-5606

NPI assigned

Jun 20, 2005

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1952306557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8888 LADUE RD STE 220",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242056",
            "telephone_number": "314-644-3336",
            "fax_number": "314-644-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8888 LADUE RD STE 220",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242056",
            "telephone_number": "314-644-3336",
            "fax_number": "314-644-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VERA",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "102273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8888 LaDue Rd Ste 220",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631242056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gabrielle De Lucca Vicente
• Brendan Michael De Marco, MD
• Gayan De Silva, MD
• Katherine Mary De Souza, MD
• Larissa De Souza, MD
• Michael Doran De Vita, M.D.
• Charl J De Wet, MD
• De'Vine Connections LLC
• Deaconess Illinois Clinic, Inc
• Deaconess Illinois Specialty Clinic, Inc.

• Obstetrics & Gynecology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.