OrganizationActive
Your Village Stl LLC
NPI 1205552643 · Pediatrics Physician · Wildwood, MO
Your Village Stl LLC is a Pediatrics Physician organization in Wildwood, MO (NPI 1205552643).
Provider details
- NPI number
- 1205552643
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jennifer Tietjen, Owner(314) 753-3982
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1719 Big Horn Basin Dr
Wildwood, MO 63011-4821
Phone: (314) 753-3982
Street-level locationGet directions
Mailing address
1719 Big Horn Basin Dr
Wildwood, MO 63011-4821
Registry dates
- Enumerated
- 2022-10-18
- Last updated
- 2022-10-18
- Certified
- 2022-10-18
Frequently asked questions
- What is Your Village Stl LLC's NPI number?
- Your Village Stl LLC's National Provider Identifier (NPI) is 1205552643, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Your Village Stl LLC?
- Your Village Stl LLC is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Your Village Stl LLC located?
- Your Village Stl LLC's practice location on file with NPPES is 1719 Big Horn Basin Dr, Wildwood, MO 63011-4821.
- What is Your Village Stl LLC's phone number?
- The practice phone number listed in the NPPES registry for Your Village Stl LLC is (314) 753-3982.
- Who is the authorized official for Your Village Stl LLC?
- The authorized official listed on Your Village Stl LLC's NPPES record is Jennifer Tietjen, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Your Village Stl LLC's NPI active?
- Yes — Your Village Stl LLC's NPI (1205552643) is active in the NPPES registry as of the last update on 2022-10-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.