Jean Berra Mueller, GNP
Individual provider Active NPI Gerontology Nurse Practitioner · Saint Louis, MO
NPI 1205947173 · NPPES record last updated Feb 5, 2021
Key facts
- NPI
- 1205947173
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- 100600 (MO)
- Practice address
- 3844 S Lindbergh Blvd
Ste. 120
Saint Louis, MO 63127-1368 - Phone
- (314) 525-0490
- Fax
- (314) 525-0434
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Physician Groups LC
Practice addresses (Care Compare)
1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195
2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454
3844 S Lindbergh Blvd
Suite 210
Saint Louis, MO 63127-1387
Phone (314) 525-0420
Hospital & facility affiliations
- Mercy Hospital South
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080208000004 | MO | Practitioner - Nurse Practitioner | 8527141928 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Groups LC | Current |
Accepting new patients | |
| Physician Groups LC | Current |
Accepting new patients | |
| Physician Groups LC | Past | Accepting new patients |
Locations
2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454
3844 S Lindbergh Blvd
Ste 120
Saint Louis, MO 63127
Phone (314) 525-0434
3844 S Lindbergh Blvd
Saint Louis, MO 63127
Phone (314) 525-0420
670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 953-8250
969 N Mason Rd
Ste 160
Saint Louis, MO 63141
Phone (314) 434-8828
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 100600 | MO | Yes |
Addresses
Primary practice location
3844 S Lindbergh Blvd
Ste. 120
Saint Louis, MO 63127-1368
Mailing address
3844 S Lindbergh Blvd Ste 120
Saint Louis, MO 63127-1369
Phone (314) 525-0490
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 425802808 | Medicaid | MO |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Other providers in Saint Louis, MO
- Marc J Bernstein
- Mark Randall Bernstein
- Michael Lyn Bernstein
- Sarah Bernstein
- Sophie Bernstein
- Anthony Gerard Berra
- Ciera Berra
- Elisabeth Berra
- Sagine Audra Berry-Tony
- Andrea Maria Berry
All providers in Saint Louis, MO · Gerontology Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.