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Carla Tellor Grundy

Nursing Care in Saint Louis, MO. Organization (NPI-2).

NPI number1124367198
StatusActive
Last updated in NPPESFeb 11, 2013

Details

NPI
1124367198
Entity type
Organization (NPI-2)
Legal business name
Carla Tellor Grundy
Organization subpart
No
Enumeration date
Feb 11, 2013
Last updated
Feb 11, 2013

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251J00000X Nursing Care2008022570MOYes

Practice location

121 Park Rd
Saint Louis, MO 63119-2528

Phone 314-452-4415

Mailing address

121 Park Rd
Saint Louis, MO 63119-2528

Phone 314-452-4415

Authorized official

Carla Tellor Grundy
Speech-Language Pathologist
3144524415

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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