Individual provider Active NPI

Christina Jeanette Gaut, FNP

  • Family Nurse Practitioner
  • Saint Charles, MO
National Provider Identifier
1063091387
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F10201252 Issued in MO
Practice address
400 1St Capitol Dr
Suite 301
Saint Charles, MO 63301-2883
Phone
(636) 669-3080
NPI assigned
Apr 5, 2021
Last updated
Aug 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F10201252 MO Primary

Addresses

Primary practice location

400 1St Capitol Dr
Suite 301
Saint Charles, MO 63301-2883

Mailing address

400 1St Capitol Dr Ste 301
Saint Charles, MO 63301-2883
Phone (636) 669-3080

Other practice location 1

400 1st Capitol Dr
Saint Charles, MO 63301-2880
Phone (636) 669-3080

Other names 1

  • Christina Jeanette Withee Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cgaut31202@dirtect-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20210422000802 MO Practitioner - Nurse Practitioner 0840608345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

400 1St Capitol Dr
Suite 201
Saint Charles, MO 63301-2882
Phone (636) 669-2332

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F10201252MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group Inc. CurrentSince May 9, 2021 Accepting new patients
SSM Medical Group, Inc. CurrentSince May 9, 2021 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

400 1st Capitol Dr
Ste 201
Saint Charles, MO 63301
Phone (636) 379-6363

400 1st Capitol Dr
Ste 301
Saint Charles, MO 63301
Phone (636) 625-7715

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

Organizations & group practices 3

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

Hospital & facility affiliations 4

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": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1063091387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 1ST CAPITOL DR STE 301",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012883",
            "telephone_number": "636-669-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 1ST CAPITOL DR",
            "address_2": "SUITE 301",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012883",
            "telephone_number": "636-669-3080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 1st Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633012880",
            "country_code": "US",
            "telephone_number": "636-669-3080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAUT",
        "first_name": "CHRISTINA",
        "middle_name": "JEANETTE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "F10201252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgaut31202@dirtect-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cgaut31202@dirtect-ehr-ssmhc.com",
            "address_1": "400 1st Capitol Dr",
            "address_2": "Suite 301",
            "city": "Saint Charles",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633012883",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR-API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "400 1st Capitol Dr",
            "address_2": "Suite 301",
            "city": "Saint Charles",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633012883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "WITHEE",
            "middle_name": "JEANETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.