Dedra M Echols, AGNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

2019036546 Issued in MO

Practice address

1 Jefferson Barracks Rd
Saint Louis, MO 63125-4181

Phone

(314) 894-6654

NPI assigned

Sep 20, 2019

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1952952905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254181",
            "telephone_number": "314-894-6654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254181",
            "telephone_number": "314-894-6654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECHOLS",
        "first_name": "DEDRA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-20",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2019036546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles S Eby, MD
• Jason Eccker, LCSW
• Mara Ada Eccles, MD
• Jacquelyn Echoles
• Brenda Yvonne Echols, CMT
• Andrew Gordon Eck, MD
• Rachel Mackenzie Eck
• Donna Eckardt, MD
• John R Eckardt, MD
• Cody Marie Eckelkamp, FNP, BC

• Primary Care Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Primary Care Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; 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.