1. Home
  2. Directory
  3. Missouri
  4. Fenton
  5. Nurse Practitioner
  6. NPI Profile

REBECCA THERESA MEDLOCK AGACNP-BC
NPI 1023632932
Nurse Practitioner - Gerontology in Fenton, MO

Active since June 05, 2020
736 MARCO VALLEY CT, FENTON, MO 63026(314) 413-2187 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2025, Jul 8, 2020, Jun 17, 2020 and 1 more (4 updates tracked since 2020).

About Rebecca Theresa Medlock Agacnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REBECCA THERESA MEDLOCK AGACNP-BC (NPI 1023632932) is an individual gerontology provider in Fenton, Missouri, licensed in Missouri (2019029631) and active in the NPI registry since June 2020.

NPPES Registry Identity

NPI1023632932
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameREBECCA THERESA MEDLOCKCredential: AGACNP-BC
Location Address736 MARCO VALLEY CTFenton, MO 63026-5318
Mailing Address736 Marco Valley CtFenton, MO 63026-5318 · (314) 413-2187
Phone(314) 413-2187
Sole ProprietorYes
Enumeration DateJune 5, 2020
Last NPPES UpdateSeptember 11, 20254 updates tracked since enumeration
NPPES CertifiedJuly 8, 2020
✔ NPI 1023632932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in MO · 2019029631
736 MARCO VALLEY CT, Fenton, MO 63026
Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rebecca Medlock's NPI number?

The NPI number for Rebecca Medlock is 1023632932. It was assigned to this individual provider in the NPPES registry on June 5, 2020.

Where is Rebecca Medlock located?

Rebecca Medlock practices at 736 Marco Valley Ct, Fenton, MO 63026. The listed phone number is (314) 413-2187.

What is Rebecca Medlock's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

When was this NPI record last updated?

The NPPES record for Rebecca Medlock was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.