Individual provider Active NPI

Alante Q Ghannam, FNP

  • Family Nurse Practitioner
  • Saint Charles, MO
National Provider Identifier
1083153787
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017000787 Issued in MO
Practice address
1475 Kisker Rd Ste 200
Saint Charles, MO 63304-8788
Phone
(636) 695-0325
Fax
(636) 695-0326
NPI assigned
Feb 15, 2017
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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 2017000787 MO Primary

Addresses

Primary practice location

1475 Kisker Rd Ste 200
Saint Charles, MO 63304-8788

Mailing address

PO Box 23340
Saint Louis, MO 63156-3340
Phone (314) 645-3743

Other practice location 1

1027 Bellevue Ave
Ste 107
Saint Louis, MO 63117-1851
Phone (314) 645-3743

Other names 1

  • Alante Quanai Fletcher Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170222000141 MO Practitioner - Nurse Practitioner 3072897933 Reassigns benefits to 3 organizations
I20221208000997 IL Practitioner - Nurse Practitioner 3072897933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unity Hospice of Greater St. Louis, LLCGroup PAC ID 0446260962, 6 clinicians
Unity Hospice GSL LLCGroup PAC ID 6406037274, 8 clinicians

Practice addresses (Care Compare)

1604 Eastport Plaza Dr
Suite 102
Collinsville, IL 62234-6133
Phone (618) 346-1111

6406 Wise Ave
Saint Louis, MO 63139-3315
Phone (314) 645-8648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017000787MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Hospice GSL, LLC CurrentSince Oct 1, 2022 Accepting new patients
Unity Hospice of Greater St Louis LLC CurrentSince Oct 1, 2022 Accepting new patients
SSM Medical Group Inc. CurrentSince Jan 17, 2025 Accepting new patients
SSM Medical Group, Inc. CurrentSince Jan 17, 2025 Accepting new patients
Visiting Nurse Association of Greater St. Louis CurrentSince Aug 30, 2024 Accepting new patients
Visiting Nurse Association of Greater St. Louis Past Accepting new patients
Unity Hospice GSL, LLC Past Accepting new patients

Locations

1604 Eastport Plaza Dr
Ste 102
Collinsville, IL 62234
Phone (618) 346-1111

4101 Main St
Skokie, IL 60076
Phone (312) 847-2458

1475 Kisker Rd
Ste 200
Saint Charles, MO 63304
Phone (636) 498-5800

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

2029 Woodland Pkwy
Ste 105
Saint Louis, MO 63146
Phone (314) 918-7171

6406 Wise Ave
Saint Louis, MO 63139
Phone (314) 636-4891

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1083153787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23340",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631563340",
            "telephone_number": "314-645-3743",
            "fax_number": "314-647-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 KISKER RD STE 200",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633048788",
            "telephone_number": "636-695-0325",
            "fax_number": "636-695-0326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1027 Bellevue Ave",
            "address_2": "STE 107",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631171851",
            "country_code": "US",
            "telephone_number": "314-645-3743",
            "fax_number": "314-647-7967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHANNAM",
        "first_name": "ALANTE",
        "middle_name": "Q",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017000787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALANTE",
            "last_name": "FLETCHER",
            "middle_name": "QUANAI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.