Michelle R Mick, ANP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2016035597 Issued in MO

Practice address

3015 N Ballas Rd
Saint Louis, MO 63131-2329

Phone

(314) 996-5772

NPI assigned

Nov 28, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sound Physicians of Illinois LLCGroup PAC ID 1557533734, 193 clinicians

Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
• Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
• SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
• SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1285664268
  Medicare reassignment Care Compare group NPD
• Sound Physicians of Illinois, LLC

  • Hospitalist Physician
  • Bridgeton, MO
  • NPI 1043598865
  Medicare reassignment Care Compare group
• Cogent Healthcare of Missouri, Inc

  • Critical Care Medicine (Internal Medicine) Physician
  • Fenton, MO
  • NPI 1780961599
  Medicare reassignment NPD
• Galen Inpatient Physicians PC.

  • Hospitalist Physician
  • Fenton, MO
  • NPI 1538714688
  Medicare reassignment NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  MO, Nurse Practitioner

  Medicare reassignment NPD
• Steven Crawford, DO

  • Family Medicine Physician
  • De Soto, MO
  • NPI 1548266737
  Medicare reassignment
• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Farmington, MO
  • NPI 1427114990
  NPD
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Los Angeles, CA
  • NPI 1205787686
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Charles, MO
  • NPI 1467521146
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Bridgeton, MO
  • NPI 1598835308
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Lake St Louis, MO
  • NPI 1871665380
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1033652862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-5772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Jefferson Sq",
            "address_purpose": "LOCATION",
            "city": "DE Soto",
            "state": "MO",
            "postal_code": "630201031",
            "country_code": "US",
            "telephone_number": "636-586-6685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICK",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2023-10-12",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2016035597",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2016035597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3015 N Ballas Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michigan Complete Health, Inc.
• Laura Michler, NP
• Mary Ilene Michler, DTR
• Michael Thomas Michler
• Thomas Lee Michler, M.ED.
• Kelly Mickey, PHARMD
• Walter Lee Mickey, D.O.
• Susan Mickley, CPM
• Jan Micotto, CRNA
• Teresa Lynn Micotto, M.D.

• Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.