Individual provider Active NPI

Lexxie S. Gramke, PMHNP-BC, AGPCNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1982002812
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2014040185 Issued in MO
Practice address
11116 S Towne SQ Ste 205
Saint Louis, MO 63123-7809
Phone
(314) 567-1958
NPI assigned
Dec 9, 2014
Last updated
Nov 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2014040185 MO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2014040185 MO Primary

Addresses

Primary practice location

11116 S Towne SQ Ste 205
Saint Louis, MO 63123-7809

Mailing address

11116 S Towne SQ Ste 205
Saint Louis, MO 63123-7809
Phone (314) 567-1958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150831000532 IL Practitioner - Nurse Practitioner 8325363641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Nancy M Rivas PC Flourishing Lives Counseling CenterGroup PAC ID 2961937040, 5 clinicians

Practice addresses (Care Compare)

1805 N Mill St
Suite L
Naperville, IL 60563-4860
Phone (331) 229-3123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of the University of Illinois CurrentSince Apr 9, 2024 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Apr 9, 2024 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Dr Nancy M Rivas PC Flourishing Lives Counseling Center Past Accepting new patients

Locations

1309 S Halsted St
Chicago, IL 60607
Phone (312) 413-3000

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1982002812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11116 S TOWNE SQ STE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237809",
            "telephone_number": "314-567-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11116 S TOWNE SQ STE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237809",
            "telephone_number": "314-567-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMKE",
        "first_name": "LEXXIE",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC, AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-09",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2014040185",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2014040185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.