Nichole Marie Maclellan, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2011039959 Issued in MO

Practice address

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004

Phone

(636) 735-4755

NPI assigned

Feb 29, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Aco Clinical Services IncGroup PAC ID 6901188572, 159 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: nmaclellan1006454@directc.mercy.net

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.

• Mercy Aco Clinical Services Inc

  • Neurology Physician
  • Chesterfield, MO
  • NPI 1063965093
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1043584634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772866",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770166",
            "telephone_number": "314-543-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15740 S OUTER 40 RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172004",
            "telephone_number": "636-735-4755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10700 Manchester Rd Ste E",
            "address_purpose": "LOCATION",
            "city": "Kirkwood",
            "state": "MO",
            "postal_code": "631221307",
            "country_code": "US",
            "telephone_number": "314-428-9541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACLELLAN",
        "first_name": "NICHOLE",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2011039959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luxottica Retail North America Inc
• Samantha Leigh Lybarger, MAC, CIT
• Ellen Lynch, MS,CCC-SLP
• Richard W Maack, MD
• Sandra Lynn Macke-Piper, LPC
• Lisa M Mahiger, CRNA
• Scott Mahlin, DDS
• Main Street Health Partners, P.C.
• Samera Majeed, M.D.
• Surajit Majumdar, MD, FACP

• Family Nurse Practitioner in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.