Individual provider Active NPI

Amy Schawacker, ANP

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1205060522
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2003015722 Issued in MO
Practice address
12655 Olive Blvd FL 4
Saint Louis, MO 63141
Phone
(314) 851-1000
Fax
(314) 851-4477
NPI assigned
May 14, 2009
Last updated
Aug 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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 2003015722 MO Primary

Addresses

Primary practice location

12655 Olive Blvd FL 4
Saint Louis, MO 63141

Mailing address

PO Box 23340
Saint Louis, MO 63156-3340
Phone (314) 851-1000

Other practice location 1

1551 Wall St Ste 400
Saint Charles, MO 63303-3541
Phone (636) 669-7006

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090702000050 MO Practitioner - Nurse Practitioner 7911058946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12503 Village Circle Dr
Suite 208
Saint Louis, MO 63127-1701
Phone (314) 270-7600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2003015722MOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FV Hospice by Friendship Village, LLC CurrentSince Jun 6, 2025 Accepting new patients

Locations

12503 Village Circle Dr
Ste 208
Saint Louis, MO 63127
Phone (314) 270-7600

Interoperability endpoints

  • Direct secure messaging: amy.schawacker.p2@direct.essehealth.nextgenshare.com
  • Direct secure messaging: amy.schawacker.p1@direct.essehealth.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
FV HospiceSaint Louis, MO, CCN 261706 Hospice Operational/Managerial Control Jun 9, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1205060522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23340",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631563340",
            "telephone_number": "314-851-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12655 OLIVE BLVD FL 4",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-851-1000",
            "fax_number": "314-851-4477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1551 Wall St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633033541",
            "country_code": "US",
            "telephone_number": "636-669-7006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHAWACKER",
        "first_name": "AMY",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-14",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2003015722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.