Individual provider Active NPI

Molly Lombardo, NP-C

  • Family Nurse Practitioner
  • Lake St Louis, MO
National Provider Identifier
1083136378
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F07170107 Issued in MO
Practice address
300 Medical PLZ Ste 221
Lake St Louis, MO 63367-1483
Phone
(636) 625-6041
NPI assigned
Jul 9, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 10

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.

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 Inc 565 clinicians

Practice addresses (Care Compare)

300 Medical PLZ
Suite 221
Lake St Louis, MO 63367-1483
Phone (636) 625-6041

Hospital & facility affiliations

  • SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
  • SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005

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
I20170914003347 MO Practitioner - Nurse Practitioner 6305110362 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F07170107MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group, Inc. CurrentSince Aug 1, 2018 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
SSM Depaul Medical Group, Inc. Past Accepting new patients

Locations

14021 New Halls Ferry Rd
Florissant, MO 63033
Phone (314) 839-0910

300 Medical Plz
Ste 221
Lake St Louis, MO 63367
Phone (636) 561-2229

300 Medical Plz
Ste 310
Lake St Louis, MO 63367
Phone (314) 291-6556

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

Interoperability endpoints

  • Direct secure messaging: mlombardo217379@direct-ehr-ssmhc.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F07170107 MO Primary

Addresses

NPPES NPI Registry

Primary practice location

300 Medical PLZ Ste 221
Lake St Louis, MO 63367-1483

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534

Electronic endpoints 2

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address mlombardo217379@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 4, 2020.

{
    "created_epoch": "1499558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1083136378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLZ STE 221",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671483",
            "telephone_number": "636-625-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOMBARDO",
        "first_name": "MOLLY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-09",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "F07170107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlombardo217379@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mlombardo217379@direct-ehr-ssmhc.com",
            "address_1": "300 Medical Plz Ste 221",
            "city": "Lake St Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633671483",
            "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": "300 Medical Plz Ste 221",
            "city": "Lake St Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633671483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

Verify at the official NPI Registry.