DR. NICKOLAI C DETERT (NPI# 1154987097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154987097 |
| Entity Type | Individual |
| Full Name | DR. NICKOLAI C DETERT |
| Credential | DNP, FNP-C |
| Practice Address |
12680 Olive Blvd Ste 300 Saint Louis MO 63141-6322 |
| Practice Telephone | 3142510451 |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2019019665 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
12680 OLIVE BLVD STE 300 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-6322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063568640 | Christian Verry | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2007-01-26 |
| 1013533645 | Viola Hoxha | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2020-06-19 |
| 1417573072 | Michele Sun | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2020-06-19 |
| 1639795552 | Catherine Rose Baker | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2020-06-17 |
| 1780208611 | Raphael Kai-hung Yang | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2020-06-06 |
| 1043834427 | Elizabeth Hoover | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2020-06-02 |
| 1992365092 | Shivi Yadava | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2019-06-19 |
| 1588224190 | Emily June Govro | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2019-06-17 |
| 1437718384 | Ha Thuy Hatley | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2019-06-12 |
| 1881253235 | Adam Joseph Reinagel | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2019-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720816 | Blake Christian Cory | Nurse Practitioner | 615 S Ballas Rd # 2015, Saint Louis, MO 63122-5314 | 2020-11-08 |
| 1265032346 | Sara Lynn Gillespie | Nurse Practitioner | 2424 S 9th St Apt 215, Saint Louis, MO 63104-4717 | 2020-10-28 |
| 1174123509 | Megan Ashley Wagner | Nurse Practitioner | 10012 Kennerly Rd Ste 406, Saint Louis, MO 63128-2197 | 2020-10-26 |
| 1467059972 | Anissa Rasul | Nurse Practitioner | 10631 Thayer Dr, Saint Louis, MO 63123-6018 | 2020-10-07 |
| 1124635388 | Brittney Sherrell Burks | Nurse Practitioner | 10314 Briar Hollow Dr Apt 7, Saint Louis, MO 63146-5777 | 2020-09-30 |
| 1629684865 | Nicole Burdge | Nurse Practitioner | 9230 Laurel Hill Dr, Saint Louis, MO 63126-2820 | 2020-09-22 |
| 1932724614 | Oluwatoyin Olufunke Adegboyega | Nurse Practitioner | 3318 Saint Vincent Ave, Saint Louis, MO 63104-1338 | 2020-06-09 |
| 1497376487 | Jessica A Spring | Nurse Practitioner | 6023 Lansdowne Ave, Saint Louis, MO 63109-2243 | 2020-04-30 |
| 1932728466 | Lucy Wachuka Kamau | Nurse Practitioner | 4412 Clarence Ave, Saint Louis, MO 63115-3108 | 2020-04-14 |
| 1275169567 | Lindsay Jones | Nurse Practitioner | 1115 Olivette Executive Pkwy Ste 100, Saint Louis, MO 63132-3265 | 2020-03-18 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
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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.