Individual provider Active NPI

Elizabeth McCarter Noonan, M.D.

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1154852598
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2020015474 Issued in MO
Practice address
1465 S Grand Blvd RM 2717
1465 South Grand Blvd, RM 2717
Saint Louis, MO 63104-1003
Phone
(314) 577-5634
Fax
(314) 577-5616
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2020015474 MO Primary

Addresses

Primary practice location

1465 S Grand Blvd RM 2717
1465 South Grand Blvd, RM 2717
Saint Louis, MO 63104-1003

Mailing address

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 577-5680

Other names 1

  • Elizabeth Joan McCarter Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address enoonan147697@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200819001479 MO Practitioner - Pediatric Medicine 1153699046 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2020015474MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Cardinal Glennon Children'S Hospital Pediatrics CurrentSince Jul 1, 2020 Accepting new patients
SSM Cardinal Glennon Childrens Hospital Pediatrics CurrentSince Jul 1, 2020 Accepting new patients
SSM Health Care St. Louis CurrentSince Jul 1, 2020 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Health Care Group Pediatrics CurrentSince Jul 1, 2022 Accepting new patients
SSM Health Care St Louis CurrentSince Jul 1, 2020 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
SSM Medical Group Inc. Past Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

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

1465 S Grand Blvd
Rm 2717
Saint Louis, MO 63104
Phone (314) 268-4070

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

Interoperability endpoints

  • Direct secure messaging: enoonan147697@direct-ehr-ssmhc.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1154852598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5680",
            "fax_number": "314-268-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD RM 2717",
            "address_2": "1465 SOUTH GRAND BLVD, RM 2717",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5634",
            "fax_number": "314-577-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "ELIZABETH",
        "middle_name": "MCCARTER",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2020015474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "enoonan147697@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "enoonan147697@direct-ehr-ssmhc.com",
            "address_1": "1465 S Grand Blvd Rm 2717",
            "address_2": "1465 SOUTH GRAND BLVD, RM 2717",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041003",
            "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": "1465 S Grand Blvd Rm 2717",
            "address_2": "1465 SOUTH GRAND BLVD, RM 2717",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "MCCARTER",
            "middle_name": "JOAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.