Individual provider Active NPI

Angela Kay Roethemeyer, ANP

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1164846648
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2012025987 Issued in MO
Practice address
114 N Taylor Ave
Saint Louis, MO 63108-2102
Phone
(314) 534-8600
Fax
(314) 652-8138
NPI assigned
Feb 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2012025987 MO Primary

Addresses

Primary practice location

114 N Taylor Ave
Saint Louis, MO 63108-2102

Mailing address

PO Box 503954
Saint Louis, MO 63150-3954
Phone (314) 534-8600

Other identifiers 1

IdentifierTypeStateIssuer
420014221MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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
I20140714002309 MO Practitioner - Nurse Practitioner 9537384227 Reassigns benefits to 1 organization
I20250425000783 IL Practitioner - Nurse Practitioner 9537384227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

705 S Grand
Nashville, IL 62263-1534

705 S Grand St
Nashville, IL 62263-1534
Phone (618) 327-8236

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Washington County Hospital District CurrentSince Mar 1, 2025 Accepting new patients
Washington County Hospital District CurrentSince Mar 1, 2025 Accepting new patients
Washington University Clinical Associates LLC Current Accepting new patients
Washington University CurrentSince Oct 1, 2017 Accepting new patients
Washington County Hospital District Past Accepting new patients
Washington County Hospital District Past Accepting new patients

Locations

705 S Grand St
Nashville, IL 62263
Phone (618) 327-2200

1245 S Mill St
Nashville, IL 62263
Phone (618) 327-8119

114 N Taylor Ave
Saint Louis, MO 63108
Phone (314) 534-8600

4240 Duncan Ave
Ste 301
Saint Louis, MO 63110

Interoperability endpoints

  • Direct secure messaging: aroethemeyer528718@direct-ehr-ssmhc.com

Organizations & group practices 6

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 4

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": "1391558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1164846648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 503954",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631503954",
            "telephone_number": "314-534-8600",
            "fax_number": "314-652-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N TAYLOR AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082102",
            "telephone_number": "314-534-8600",
            "fax_number": "314-652-8138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROETHEMEYER",
        "first_name": "ANGELA",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-05",
        "last_updated": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2012025987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420014221",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "114 N Taylor Ave",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631082102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.