MISS KELLY E COMPAS AGACNP-BC NPI 1770559668

NPI Information

NPI: 1770559668
Provider Name: MISS KELLY E COMPAS, AGACNP-BC
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
3009 N BALLAS RD
SUITE 359C
SAINT LOUIS, MO
ZIP 63131
Phone: (314) 996-4545
Get Directions

MISS Kelly E Compas, AGACNP-BC is a gerontology nurse practitioner in Saint Louis, MO. MISS Kelly E Compas, AGACNP-BC NPI is 1770559668. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3009 N BALLAS RD
SUITE 359C
SAINT LOUIS, MO
ZIP 63131-322
Phone: (314) 996-4545
Fax: (314) 996-4546

The NPI 1770559668 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/28/2006 and was last updated on 2/20/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	131702	MISSOURI	No
2	363LG0600X	Nurse Practitioner	Gerontology	131702	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	819584175	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI
2	424892818	MEDICAID	MISSOURI
3	P03174	MEDICARE UPIN	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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