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

Kelly Renee Mebruer

Individual provider Surgical Physician Assistant · NPI 1144189788

Kelly Renee Mebruer is a Physician Assistant in Saint Louis, Missouri. Graduated from Saint Louis University School of Medicine in 2025, 1 year ago. Licensed in Missouri.

Years since qualifying
1
Trained at
Saint Louis University School of Medicine
Licensed in
MO
In the registry since
2026
Specialties on file
2
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Practice location Address checks out

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone: (314) 577-5600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X
Physician Assistant Taxonomy 363A00000X · Licence 2026005849 (MO)

Record details

NPI number1144189788
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 20, 2026
Last updated in NPPESMarch 10, 2026
Certification dateMarch 10, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolSAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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