Stacey A Mormol, CRNA

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

123598 Issued in MO

Practice address

1015 Bowles Ave
Fenton, MO 63026-2394

Phone

(636) 496-2000

NPI assigned

May 21, 2010

Last updated

Aug 29, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stacey A Keller Former name

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metro-West Anesthesia Group IncGroup PAC ID 2163329921, 204 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
• SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081
• SSM Health St Mary's Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Metro-West Anesthesia Group Inc

  • Anesthesiology Physician
  • Chesterfield, MO
  • NPI 1245427335
  Medicare reassignment Care Compare group NPD

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

• SSM Health Care St. Louis

  dba SSM Health Cardinal Glennon Children's Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1336387836
  Care Compare affiliation
• SSM Health Care St. Louis

  dba SSM Health DePaul Hospital - St. Louis

  • General Acute Care Hospital
  • Bridgeton, MO
  • NPI 1598835308
  Care Compare affiliation
• SSM Health Care St. Louis

  dba SSM Health St. Clare Hospital - Fenton

  • General Acute Care Hospital
  • Fenton, MO
  • NPI 1851496152
  Care Compare affiliation
• SSM Health Care St. Louis

  dba SSM Health St. Mary's Hospital - St. Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1962572396
  Care Compare affiliation

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

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1083933626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13515 BARRETT PARKWAY DR STE 170",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630215870",
            "telephone_number": "314-775-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 BOWLES AVE",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262394",
            "telephone_number": "636-496-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORMOL",
        "first_name": "STACEY",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-21",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "123598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "KELLER",
            "middle_name": "A",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Missouri Medical Partners LLC
• Joseph Walter Moleski Jr., D.O.
• Thomas L Monje, OD
• Marco Moreno, R.EEG T.
• Kurt Richard Morgester, D.M.D.
• Rebecca Morris, PT
• Sequita M Morris, MD
• Barry A Morrison, M.ED.
• Melissa Ann Muench, D.O.
• Katherine L Mulherin, N.P.

• Anesthesiology Physician in Fenton, MO
• Providers in Fenton, MO by specialty
• Anesthesiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.