=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356644306
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | URGENT CARE FOR KIDS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/14/2010
-----------------------------------------------------
Last Update Date | 10/12/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1413 WENTZVILLE PKWY
-----------------------------------------------------
City | WENTZVILLE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63385
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 636-332-5400
-----------------------------------------------------
Fax | 636-332-5404
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1413 WENTZVILLE PKWY
-----------------------------------------------------
City | WENTZVILLE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63385
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 636-332-5400
-----------------------------------------------------
Fax | 636-332-5404
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MEGHAN AMES
-----------------------------------------------------
Credential | RN, PPCNP-BC
-----------------------------------------------------
Telephone | 314-707-4670
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------