Active NPI
Emily Katherine Wambold, PNP
- Pediatric Nurse Practitioner
- Saint Louis, MO
National Provider Identifier
1962672568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 2004017952
- Practice address
- 1 Childrens PL
Third Floor
Saint Louis, MO 63110-1002 - Phone
- (314) 454-6162
- Fax
- (314) 454-2174
- NPI assigned
- Mar 10, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 2004017952 | MO | Primary |
Addresses
Primary practice location
1 Childrens PL
Third Floor
Saint Louis, MO 63110-1002
Mailing address
660 S Euclid Ave
C B 8115
Saint Louis, MO 63110-1010
Phone (314) 454-6162
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247702400000",
"number": "1962672568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 S EUCLID AVE",
"address_2": "C B 8115",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101010",
"telephone_number": "314-454-6162",
"fax_number": "314-454-2174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL",
"address_2": "THIRD FLOOR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101002",
"telephone_number": "314-454-6162",
"fax_number": "314-454-2174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAMBOLD",
"first_name": "EMILY",
"middle_name": "KATHERINE",
"name_prefix": "Ms.",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-10",
"last_updated": "2009-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MO",
"license": "2004017952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.