MRS. JACQUELINE LEE CARR (NPI# 1801147962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801147962 |
| Entity Type | Individual |
| Full Name | MRS. JACQUELINE LEE CARR |
| Credential | ANP |
| Practice Address |
12990 Manchester Rd 101 Des Peres MO 63131-1860 |
| Mailing Address |
12990 Manchester Road 101 Des Peres MO 63131-1860 |
| Practice Telephone | 3145673567 |
| Practice Fax Number | 3145676575 |
| Mailing Telephone | 3145673567 |
| Mailing Fax Number | 3145676575 |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2012-09-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
2012015191 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396123337 | Jacqueline Carr | Occupational Therapist | 1931 Black Rock Tpke, Fairfield, CT 06825-3506 | 2015-05-11 |
| 1114299427 | Jacqueline Ann Carr | Physical Therapist | 6301 Forest Hills Dr Ne, Albuquerque, NM 87109-4137 | 2012-02-01 |
| 1003029968 | Jacqueline Carr | Social Worker | 511 Perry St, Defiance, OH 43512-2123 | 2007-05-08 |
| 1710190764 | Jacqueline M Carr | Hearing Instrument Specialist | 3220 South Higuera Street, Suite 320, San Luis Obispo, CA 93401-6987 | 2007-05-07 |
| Street Address |
12990 MANCHESTER RD 101 |
| City | DES PERES |
| State | MO |
| Zip Code | 63131-1860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265873475 | Michelle Derheimer | Optometrist | 12990 Manchester Rd, Suite 201, Des Peres, MO 63131-1860 | 2013-07-16 |
| 1104004134 | Tara Lynn Weirich | Nurse Anesthetist, Certified Registered | 12990 Manchester Rd, Des Peres, MO 63131-1860 | 2008-01-31 |
| 1780865220 | Ophthalmology Consultants, LLC. | Ophthalmology | 12990 Manchester Rd, 201, Des Peres, MO 63131-1804 | 2007-11-26 |
| 1942497805 | Ophthalmic Plastic & Cosmetic Surgery, Inc. | Specialist | 12990 Manchester Rd, Suite 102, Des Peres, MO 63131-1804 | 2007-09-25 |
| 1427273440 | Endoscopy Center of St. Louis, LLC | Clinic/Center | 12990 Manchester Rd, Suite 1, Des Peres, MO 63131-1804 | 2007-04-16 |
| 1740307354 | Byron A Santos-flores | Specialist | 12990 Manchester Rd, Suite 201, Des Peres, MO 63131-1860 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568097954 | Avalcare Inc | Pharmacy | 10431 Clayton Rd, Saint Louis, MO 63131 | 2020-03-06 |
| 1891331369 | Life Clinic of Mo Dc PC | Chiropractor | 2051 South Lindbergh Blvd, Frontenac, MO 63131 | 2019-11-20 |
| 1447892542 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 30 S Lindbergh Blvd, Saint Louis, MO 63131 | 2019-10-10 |
| 1336797026 | Justa Davis | Dietitian, Registered | 3015 North Ballas, Saint Louis, MO 63131 | 2019-08-27 |
| 1730695362 | Curators of The University of Missouri | Psychologist | 12837 Flushing Meadows Drive, Sutie 220, Town and Country, MO 63131 | 2017-12-19 |
| 1770012031 | Danielle Marie Hargate | Specialist/Technologist | 732 Timber Trail, Frontenac, MO 63131 | 2017-06-08 |
| 1285087429 | Kathryn Parker | Internal Medicine | 1000 Des Peres Rd Ste 300, Saint Louis, MO 63131 | 2016-07-22 |
| 1437524360 | Julie Ann Godefroid | Nurse Practitioner | 1010 Old Des Peres Road, St. Louis, MO 63131 | 2015-12-03 |
| 1073982435 | Rebecca Baum Rainbolt | Social Worker | 12210 Clayton Rd, Saint Louis, MO 63131 | 2015-09-16 |
| 1518217322 | Advanced Anesthesia and Pain Management, LLC | Anesthesiology | 12805 Topping Woods Estate Drive, St. Louis, MO 63131 | 2012-09-19 |
| Find all providers in zip 63131 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619285 | Jennifer Lee Speiser | Nurse Practitioner | 12545 Olive Blvd, Saint Louis, MO 63141-6311 | 2020-11-04 |
| 1215537220 | John Franklin Niswonger | Nurse Practitioner | 861 Canyon Trl, Jackson, MO 63755-4001 | 2020-10-28 |
| 1972119014 | Michael Christopher Hassert | Nurse Practitioner | 2290 Graystone Dr, Saint Charles, MO 63303-5159 | 2020-09-22 |
| 1265045264 | Andrea Jane Montgomery | Nurse Practitioner | 444 Honeysuckle Ln, Saint Louis, MO 63119-4521 | 2020-08-28 |
| 1710596424 | Clay Thornburg | Nurse Practitioner | 602 S Home St, Palmyra, MO 63461-1747 | 2020-07-28 |
| 1396362224 | Erin M Kehoe | Nurse Practitioner | 12973 Olive Blvd, Saint Louis, MO 63141-6149 | 2020-06-26 |
| 1508482506 | Matthew Dale Tieskoetter | Nurse Practitioner | 333 S Kirkwood Rd Ste 203, Saint Louis, MO 63122-6161 | 2020-06-25 |
| 1497391924 | Stephnie Michelle Wriedt | Nurse Practitioner | 1605 E Broadway Ste 250, Columbia, MO 65201-8031 | 2019-11-19 |
| 1861033615 | Benedicta Esi | Nurse Practitioner | 6024 Pennsylvania Ave, Saint Louis, MO 63111-2555 | 2019-10-02 |
| 1245896893 | Katina D Smith | Nurse Practitioner | 8820 Mcnulty Dr, Saint Louis, MO 63114-4146 | 2019-05-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.