Healthcare Provider Details

I. General information

NPI: 1164930368
Provider Name (Legal Business Name): SARA MATHEWS RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA J. PILCHER RD

II. Dates (important events)

Enumeration Date: 01/22/2018
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 S NEW BALLAS RD STE 2007B
SAINT LOUIS MO
63141-8265
US

IV. Provider business mailing address

621 S NEW BALLAS RD STE 2007B
SAINT LOUIS MO
63141-8265
US

V. Phone/Fax

Practice location:
  • Phone: 314-991-5000
  • Fax: 314-991-5035
Mailing address:
  • Phone: 314-991-5000
  • Fax: 314-991-5035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2019038068
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164007260
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: