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

Mr. Jeffrey Michael Ditter, NP

Individual provider Nurse Practitioner · NPI 1508307190

Mr. Jeffrey Michael Ditter, NP is a Nurse Practitioner in Lake St Louis, Missouri. Qualified in 2016, 10 years ago. Practices with Skaggs Community Hospital Association, a 212-clinician group and accepts Medicare assignment. Licensed in Iowa and Missouri.

Years since qualifying
10
Licensed in
IA, MO
In the registry since
2017
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

100 Medical Plz
Lake St Louis, MO 63367-1366
Phone: (636) 625-5200
Fax: (636) 625-5314
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 2017004715 (MO)
Nurse Practitioner Taxonomy 363L00000X · Licence A155084 (IA)

Record details

NPI number1508307190
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedMarch 15, 2017
Last updated in NPPESJanuary 13, 2021
Certification dateJanuary 13, 2021
Mailing address200 Corporate Blvd, Lafayette, LA 70508-3870

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Skaggs Community Hospital Association — 212 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Lake St Louis