NP Health Information Station LLC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2011023084 Issued in MO

Legal business name

NP HEALTH INFORMATION STATION LLC

Practice address

3391 N Highway 67
Florissant, MO 63033-1604

Phone

(314) 585-1002

Fax

(314) 736-1247

NPI assigned

Jun 6, 2018

Organization subpart

No

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

Authorized official

Name

Jeanetta Renee Stomer, NURSEPRACTITIONERNPI 1609319144

Title

Co-Owner

Phone

(314) 585-1002

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeanetta Stomer

  • Family Nurse Practitioner
  • Florissant, MO
  • NPI 1609319144
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585353600000",
    "number": "1184116014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3391 N HIGHWAY 67",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630331604",
            "telephone_number": "314-585-1002",
            "fax_number": "314-736-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3391 N HIGHWAY 67",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630331604",
            "telephone_number": "314-585-1002",
            "fax_number": "314-736-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NP HEALTH INFORMATION STATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-06",
        "last_updated": "2020-03-28",
        "certification_date": "2020-03-28",
        "status": "A",
        "authorized_official_last_name": "STOMER",
        "authorized_official_first_name": "JEANETTA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "314-585-1002",
        "authorized_official_credential": "NURSEPRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2011023084",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2004029626",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Florissant, MO
• Providers in Florissant, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.