Individual provider Active NPI

Samantha Christine Kizer, NP

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1083429526
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2025003957 Issued in MO
Practice address
1225 S Grand Blvd
Saint Louis, MO 63104-1016
Phone
(314) 977-6082
NPI assigned
Feb 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2025003957 MO Primary
Family Nurse Practitioner 363LF0000X 2025003957 MO

Addresses

Primary practice location

1225 S Grand Blvd
Saint Louis, MO 63104-1016

Mailing address

1225 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2555

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
I20250305003480 MO Practitioner - Nurse Practitioner 7810418944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

Hospital & facility affiliations

  • SSM Health Saint Louis University Hospital Hospital, Saint Louis, MO, CCN 260105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025003957MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Mar 1, 2025 Accepting new patients
SSM Health Care Group CurrentSince Mar 1, 2025 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients

Locations

1225 S Grand Blvd
#45
Saint Louis, MO 63104

1225 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-3390

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1083429526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041016",
            "telephone_number": "314-617-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041016",
            "telephone_number": "314-977-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZER",
        "first_name": "SAMANTHA",
        "middle_name": "CHRISTINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-11",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2025003957",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025003957",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.