Individual provider Active NPI

Shearita Sandoval, ANP- BC

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1053705392
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2014043293 Issued in MO
Practice address
3113 Magnolia Ave
Apt 2E
Saint Louis, MO 63118-1271
Phone
(314) 749-6708
NPI assigned
Mar 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2014043293 MO Primary

Addresses

Primary practice location

3113 Magnolia Ave
Apt 2E
Saint Louis, MO 63118-1271

Mailing address

5471 Dr. Martin Luther King Dr.
Saint Louis, MO 63112-4265
Phone (314) 367-5820

Other practice location 1

472 N Highway 67 St
Florissant, MO 63031-5102
Phone (314) 343-5061

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150805007211 MO Practitioner - Nurse Practitioner 4385958206 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Health CentersGroup PAC ID 7911815097, 53 clinicians
Oak Street Health Physicians Group of Missouri LLCGroup PAC ID 7315340213, 25 clinicians

Practice addresses (Care Compare)

401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone 31448116151306

4352 Manchester Ave
Saint Louis, MO 63110-2138
Phone 31448116151306

472 N Hwy 67 St
Florissant, MO 63031-5102
Phone (314) 967-1465

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of St Louis Division of Fiscal Management CurrentSince Apr 1, 2024 Accepting new patients
Family Care Health Centers CurrentSince Nov 18, 2025 Accepting new patients
County of St Louis Division of Fiscal Management CurrentSince Apr 1, 2024 Accepting new patients
Oak Street Health Physicians Group of Missouri, LLC CurrentSince Sep 29, 2025 Accepting new patients

Locations

472 N Highway 67 St
Florissant, MO 63031
Phone (314) 343-5061

3843 Gravois Ave
Saint Louis, MO 63116
Phone (314) 888-0981

4352 Manchester Ave
Saint Louis, MO 63110
Phone (314) 371-0336

6121 N Hanley Rd
#C
Saint Louis, MO 63134
Phone (314) 615-0500

6121 N Hanley Rd
Saint Louis, MO 63134
Phone (314) 522-6410

401 Holly Hills Ave
Saint Louis, MO 63111
Phone (314) 353-5190

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1053705392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5471 DR. MARTIN LUTHER KING DR.",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631124265",
            "telephone_number": "314-367-5820",
            "fax_number": "314-367-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 MAGNOLIA AVE",
            "address_2": "APT 2E",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631181271",
            "telephone_number": "314-749-6708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "472 N Highway 67 St",
            "address_purpose": "LOCATION",
            "city": "Florissant",
            "state": "MO",
            "postal_code": "630315102",
            "country_code": "US",
            "telephone_number": "314-343-5061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "SHEARITA",
        "credential": "ANP- BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2014043293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.