Individual provider Active NPI

Hannah Ann Wuellner, AGACNP

  • Acute Care Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1245977040
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2022029614 Issued in MO
Practice address
12700 Southfork Rd Ste 280
Saint Louis, MO 63128-3287
Phone
(314) 525-8926
NPI assigned
May 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2022029614 MO Primary
Acute Care Nurse Practitioner 363LA2100X STUDENT MO

Addresses

Primary practice location

12700 Southfork Rd Ste 280
Saint Louis, MO 63128-3287

Mailing address

4932 Delor St
Saint Louis, MO 63109-2905
Phone (919) 280-3658

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
I20220815002786 MO Practitioner - Nurse Practitioner 8921481540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Pulmonology - St. Louis, LLCGroup PAC ID 2365599925, 23 clinicians

Practice addresses (Care Compare)

12700 Southfork Rd
Suite 280
Saint Louis, MO 63128-3287
Phone (314) 892-6565

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
STUDENTMOMDAnesthesiology Physician
2022029614MOMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Pulmonology - St. Louis, LLC CurrentSince Aug 22, 2022 Accepting new patients

Locations

12700 Southfork Rd
Ste 280
Saint Louis, MO 63128
Phone (314) 525-4990

621 S New Ballas Rd
Ste 228A
Saint Louis, MO 63141
Phone (314) 251-4966

Interoperability endpoints

  • Direct secure messaging: hwuellner988103@directc.mercy.net

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 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": "1652400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1245977040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4932 DELOR ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092905",
            "telephone_number": "919-280-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 280",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283287",
            "telephone_number": "314-525-8926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUELLNER",
        "first_name": "HANNAH",
        "middle_name": "ANN",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-13",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2022029614",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "STUDENT",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.