Individual provider Active NPI

Kara J Stackley, NP

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1306146295
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2010034962 Issued in MO
Practice address
30 Ronnies PLZ
Saint Louis, MO 63126-3552
Phone
(314) 748-5800
NPI assigned
Oct 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2010034962 MO Primary

Addresses

Primary practice location

30 Ronnies PLZ
Saint Louis, MO 63126-3552

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534

Other practice location 1

3619 Richardson Square Dr
Ste 170
Arnold, MO 63010-6022
Phone (636) 717-6776

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kstackley492029@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20111017000465 MO Practitioner - Nurse Practitioner 6901078955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

30 Ronnies PLZ
Saint Louis, MO 63126-3552
Phone (314) 748-5800

Hospital & facility affiliations

  • SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081
  • SSM Health St Mary'S Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010034962MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group Inc. CurrentSince Feb 1, 2024 Accepting new patients
SSM Medical Group, Inc. CurrentSince Feb 1, 2024 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

917 Chesterfield Pkwy E
Chesterfield, MO 63017
Phone (314) 687-2719

920 N Main St
O Fallon, MO 63366
Phone (314) 687-2731

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

30 Ronnies Plz
Sappington, MO 63126
Phone (314) 748-5800

Organizations & group practices 3

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": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1306146295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 RONNIES PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631263552",
            "telephone_number": "314-748-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3619 Richardson Square Dr",
            "address_2": "STE 170",
            "address_purpose": "LOCATION",
            "city": "Arnold",
            "state": "MO",
            "postal_code": "630106022",
            "country_code": "US",
            "telephone_number": "636-717-6776",
            "fax_number": "314-525-4055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACKLEY",
        "first_name": "KARA",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2010034962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kstackley492029@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kstackley492029@direct-ehr-ssmhc.com",
            "address_1": "30 Ronnies Plz",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631263552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "30 Ronnies Plz",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631263552",
            "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.