Holly Ackermann, FNP
Individual provider Active NPI Family Nurse Practitioner · De Soto, MO
NPI 1003303389 · NPPES record last updated Feb 12, 2026
Key facts
- NPI
- 1003303389
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2018010406 (MO)
- Practice address
- 120 Boyd St
De Soto, MO 63020-1702 - Phone
- (636) 282-0380
- NPI assigned
- Apr 22, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Midwest Medical Practitioners LLC
American Multispecialty Group Inc
Practice addresses (Care Compare)
5000 Cedar Plaza Pkwy
Suite 300
Saint Louis, MO 63128-3891
Phone (636) 282-0380
5034 Griffin Rd
Saint Louis, MO 63128-3418
Phone (314) 843-7333
Hospital & facility affiliations
- Mercy Hospital Jefferson
- Brooking Park
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180814004186 | MO | Practitioner - Nurse Practitioner | 6608125281 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018010406 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West County Rheumatology, LLC | Rheumatology | Current |
Accepting new patients |
| American Multispecialty Group Inc. | Nurse Practitioner | Current |
Accepting new patients |
| Southern Illinois Internal Medicine LTD | Past | Accepting new patients | |
| American Arthritis & Rheumatology Associates - Mo LLC | Rheumatology | Past | Accepting new patients |
Locations
5034 Griffin Rd
Saint Louis, MO 63128
Phone (314) 645-3743
13100 Manchester Rd
Ste 85
Saint Louis, MO 63131
Phone (314) 983-9898
13100 Manchester Rd
Ste 70
Saint Louis, MO 63131
Phone (314) 492-2323
13100 Manchester Rd
#70
Saint Louis, MO 63131
Phone (314) 492-2323
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 2018010406 | MO | |
| Family Nurse Practitioner | 363LF0000X | 2018010406 | MO | Yes |
| Rheumatology Physician | 207RR0500X | 2018010406 | MO |
Addresses
Primary practice location
120 Boyd St
De Soto, MO 63020-1702
Mailing address
5000 Cedar Plaza Pkwy Ste 300
Saint Louis, MO 63128-3891
Phone (636) 282-0380
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2018010406 | Other | MO | MO STATE LICENSE |
Other providers in De Soto, MO
All providers in De Soto, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.