Individual provider Active NPI

Sydney Irwin

  • Family Nurse Practitioner
  • Saint Charles, MO
National Provider Identifier
1316752363
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2025019598 Issued in MO
Practice address
1475 Kisker Rd Ste 200
Saint Charles, MO 63304-8788
Phone
(636) 498-5810
NPI assigned
Feb 7, 2025
Last updated
Oct 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2025019598 MO Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1475 Kisker Rd Ste 200
Saint Charles, MO 63304-8788

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534
Phone (636) 498-5810

Other practice location 1

2424 S 9th St Apt 218
Saint Louis, MO 63104-4717
Phone (573) 280-2127

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
I20250710004119 MO Practitioner - Nurse Practitioner 5890200794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

1475 Kisker Rd
Suite 200
Saint Charles, MO 63304-8788
Phone (636) 498-5850

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025019598MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group Inc. CurrentSince Jul 3, 2025 Accepting new patients
SSM Medical Group, Inc. CurrentSince Jul 3, 2025 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

1475 Kisker Rd
Ste 200
Saint Charles, MO 63304
Phone (636) 498-5800

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1738886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1316752363",
    "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",
            "telephone_number": "636-498-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 KISKER RD STE 200",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633048788",
            "telephone_number": "636-498-5810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2424 S 9th St Apt 218",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631044717",
            "country_code": "US",
            "telephone_number": "573-280-2127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "SYDNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-07",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025019598",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.