Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Daniel T Ceballos, AGNP

Individual provider Gerontology Nurse Practitioner · NPI 1992535330

Daniel T Ceballos, AGNP is a Nurse Practitioner in Saint Louis, Missouri. Qualified in 2017, 9 years ago. Practices with Family Care Health Centers, a 52-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
9
Licensed in
MO
In the registry since
2024
Specialties on file
2
What do these letters mean?
AGNP — Adult-Gerontology Nurse Practitioner
A nurse practitioner focused on adults and older people.

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Practice location Address checks out

12655 Olive Blvd Fl 4
Saint Louis, MO 63141-6291
Phone: (314) 394-7444
Fax: (314) 627-8957
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 2024026725 (MO)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 2024026725 (MO)

Record details

NPI number1992535330
Entity typeIndividual (Type 1)
GenderMale
Credentials AGNP
Sole proprietorNo
NPI enumeratedAugust 1, 2024
Last updated in NPPESAugust 1, 2024
Certification dateAugust 1, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Family Care Health Centers — 52 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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