Individual provider Active NPI

Susan Mary Jones, AGNP

  • Gerontology Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1316458870
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
2017035894 Issued in MO
Practice address
1 Barnes Jewish Hospital PLZ
Div Ortho Surg Adult Reconstructive Surg
Saint Louis, MO 63110-1003
Phone
(314) 747-2551
Fax
(314) 747-2598
NPI assigned
Oct 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 2017035894 MO Primary

Addresses

Primary practice location

1 Barnes Jewish Hospital PLZ
Div Ortho Surg Adult Reconstructive Surg
Saint Louis, MO 63110-1003

Mailing address

660 S Euclid Ave
CB 8233
Saint Louis, MO 63110-1010
Phone (314) 514-3500

Other identifiers 1

IdentifierTypeStateIssuer
420061008MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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
I20181015001294 MO Practitioner - Nurse Practitioner 6507118841 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017035894MOMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Apr 1, 2020 Accepting new patients
Washington University Past Accepting new patients

Locations

4455 Duncan Ave
Saint Louis, MO 63110
Phone (314) 658-3800

660 S Euclid Ave
#8233
Saint Louis, MO 63110
Phone (314) 747-2555

660 S Euclid Ave
Stop 8221871800
Saint Louis, MO 63110

4921 Parkview Pl
Ste 6A6B12A
Saint Louis, MO 63110
Phone (314) 747-2551

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-1700

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1316458870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8233",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-514-3500",
            "fax_number": "314-747-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "address_2": "DIV ORTHO SURG ADULT RECONSTRUCTIVE SURG",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-747-2551",
            "fax_number": "314-747-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SUSAN",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2017035894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420061008",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_2": "Div Ortho Surg Adult Reconstructive Surg",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101003",
            "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.