MS. TRALISSA S LOVE (AGNP) – Adult Health Nurse Practitioner, NPI 1639644552

MS. TRALISSA S LOVE (AGNP) is a healthcare provider. based in Maryland heights, Missouri. specializing in NURSE PRACTITIONER. They hold the professional credentials AGNP. They hold a License No. 2018003390 (MO). The NPI Number for MS. TRALISSA S LOVE (AGNP) is 1639644552

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
MS. TRALISSA S LOVE (AGNP)
NPI
1639644552
Phone
Not provided
Address
13655 RIVERPORT DR
Enumeration Date
7 October 2018
Last Update Date
17 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3143621408
Graduation Year
2012 (14 years ago)
PAC ID
6608120340
Group Practice PAC ID
9830008770
Professional Enrollment ID
I20181114003606
Address ID
MO631101003SA1XXXXPLZX500

Contacts

FHIR Endpoint
https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness85
Years active:7State licenses:1Other namesUpdated within 12 months

7,017 NURSE PRACTITIONER in MO

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Provider Addresses for MS. TRALISSA S LOVE (AGNP)

  • 13655, Riverport Drive, Riverport, Maryland Heights, Saint Louis County, Missouri, 63043, United States

    MARYLAND HEIGHTS, MO 630434812

    Phone:

    Type: Mailing

  • PO BOX 7412011

    CHICAGO, IL 606742011

    Phone: (314) 362-7241

    Fax: (314) 362-0338

    Type: Mailing

  • 1 BARNES JEWISH HOSPITAL PLZ

    DIV NEURO GENERAL

    SAINT LOUIS, MO 631101003

    Phone: (314) 362-1408

    Fax: (314) 362-0338

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-11-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20181114003606INurse PractitionerMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63043)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9830008770View full group profile

Reviews

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Frequently asked questions

Does MS. TRALISSA S LOVE (AGNP) have a public NPI I can cite?
Public records show MS. TRALISSA S LOVE (AGNP) under NPI 1639644552.
Quick check: is MS. TRALISSA S LOVE (AGNP) active?
Public NPPES data shows MS. TRALISSA S LOVE (AGNP) with an active NPI status right now.
What type of care does MS. TRALISSA S LOVE (AGNP) provide?
MS. TRALISSA S LOVE (AGNP)'s profile centers on Adult Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to MS. TRALISSA S LOVE (AGNP)?
The directory associates MS. TRALISSA S LOVE (AGNP) with Maryland Heights, Missouri. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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