Active NPI
Julia Donovan, APRN
- Pediatric Nurse Practitioner
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 2019026953
- Practice address
- 1465 S Grand Blvd
Saint Louis, MO 63104-1003 - Phone
- (314) 617-2000
- NPI assigned
- Jun 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 12332 | CT | |
| Pediatric Nurse Practitioner | 363LP0200X | 2019026953 | MO | Primary |
| Registered Nurse | 163W00000X | 209287 | CT |
Addresses
Primary practice location
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Mailing address
575 Main St FL 2
Middletown, CT 06457-2845
Other practice location 1
76 New Britain Ave
Hartford, CT 06106-3305
Phone (860) 545-9300
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251014003013 | MO | Practitioner - Nurse Practitioner | 7416302732 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Saint Louis, MO 63195
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209287 | CT | MD | Registered Nurse |
| 12332 | CT | MD | Physical Therapist |
| 2019026953 | MO | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Center Inc | Current | Accepting new patients | |
| SSM Health Care Group | Current | Accepting new patients | |
| SSM Health Care Group | Current | Accepting new patients | |
| Community Health Center Inc | Current | Accepting new patients | |
| SSM Medical Group Inc. | Past | Accepting new patients |
Locations
76 New Britain Ave
Hartford, CT 06106
Phone (860) 545-9300
19 Grand St
Middletown, CT 06457
Phone (860) 323-0172
575 Main St
Ste 2
Middletown, CT 06457
1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070
2927 S Kingshighway Blvd
Saint Louis, MO 63139
Phone (314) 268-4070
10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647
Interoperability endpoints
- jgubicya227332@direct-ehr-ssmhc.com
Organizations & group practices 5
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.
-
- Dermatopathology Physician
- Saint Louis, MO
- NPI 1932844495
-
- Federally Qualified Health Center (FQHC)
- Danbury, CT
- NPI 1003332446
-
- Federally Qualified Health Center (FQHC)
- Middletown, CT
- NPI 1952591851
-
- Durable Medical Equipment & Medical Supplies
- Fenton, MO
- NPI 1124579966
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759449600000",
"number": "1154007698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "575 MAIN ST FL 2",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064572845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "314-617-2000"
}
],
"practiceLocations": [
{
"address_1": "76 New Britain Ave",
"address_purpose": "LOCATION",
"city": "Hartford",
"state": "CT",
"postal_code": "061063305",
"country_code": "US",
"telephone_number": "860-545-9300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DONOVAN",
"first_name": "JULIA",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-27",
"last_updated": "2025-10-03",
"certification_date": "2025-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CT",
"license": "12332",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MO",
"license": "2019026953",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CT",
"license": "209287",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.