Individual provider Active NPI

Susan L Hamlin, ANP-C

  • Adult Health Nurse Practitioner
  • St Charles, MO
National Provider Identifier
1366482515
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
147806 Issued in MO
Practice address
1475 Kisker Road
Suite 180
St Charles, MO 63304-8786
Phone
(636) 442-7300
Fax
(636) 442-7398
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP147806 MO
Adult Health Nurse Practitioner 363LA2200X 147806 MO Primary

Addresses

Primary practice location

1475 Kisker Road
Suite 180
St Charles, MO 63304-8786

Mailing address

PO Box 955534 Suite 100
Saint Louis, MO 63195-0001

Other identifiers 2

IdentifierTypeStateIssuer
RN147806OtherMOREGISTERED NURSE LISC.
NP147806OtherMONURSE PRACTIONER LISC.

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address shamlin24408@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
I20061108000052 MO Practitioner - Nurse Practitioner 0749287639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
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)

1475 Kisker Rd
Suite 180
Saint Charles, MO 63304-8786
Phone (636) 442-7300

Hospital & facility affiliations

  • SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
  • SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP147806MOMDNurse Practitioner
147806MOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group, Inc. CurrentSince Aug 1, 2018 Accepting new patients
SSM Medical Group Inc. CurrentSince Aug 1, 2018 Accepting new patients
Missouri Cancer Care PC Past Accepting new patients

Locations

3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044

400 Medical Plz
Ste 10
Lake St Louis, MO 63367
Phone (636) 625-6052

400 Medical Plz
Ste 100
Lake St Louis, MO 63367
Phone (636) 639-8600

1475 Kisker Rd
Ste 180
Saint Charles, MO 63304
Phone (636) 442-7300

1551 Wall St
Ste 310
Saint Charles, MO 63303
Phone (636) 669-2268

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

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

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 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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1366482515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534 SUITE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 KISKER ROAD",
            "address_2": "SUITE 180",
            "city": "ST CHARLES",
            "state": "MO",
            "postal_code": "633048786",
            "telephone_number": "636-442-7300",
            "fax_number": "636-442-7398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMLIN",
        "first_name": "SUSAN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "NP147806",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "147806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LISC.",
            "identifier": "RN147806",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTIONER LISC.",
            "identifier": "NP147806",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shamlin24408@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "shamlin24408@direct-ehr-ssmhc.com",
            "address_1": "1475 Kisker Road",
            "address_2": "Suite 180",
            "city": "St Charles",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633048786",
            "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": "1475 Kisker Road",
            "address_2": "Suite 180",
            "city": "St Charles",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633048786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Charles, MO

Sources for this page

Verify at the official NPI Registry.