Individual provider Active NPI

Susan Jane Elliott, DNP, APRN, FNP-C

  • Gerontology Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1407323132
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
F07181228 Issued in MO
Practice address
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone
(314) 977-8462
Fax
(314) 977-3370
NPI assigned
Oct 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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 2018026391 MO
Gerontology Nurse Practitioner 363LG0600X F07181228 MO Primary

Addresses

Primary practice location

1201 S Grand Blvd
Saint Louis, MO 63104-1016

Mailing address

1008 S Spring Ave FL 2
Saint Louis, MO 63110-2520
Phone (314) 977-8462

Other practice location 1

3691 Rutger St
Saint Louis, MO 63110-2515
Phone (314) 977-6828

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address selliott32274@direct-ehr-ssmhc.com Direct
FHIR URL http://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
I20190206003264 MO Practitioner - Nurse Practitioner 2163760711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Columbia School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

10101 Woodfield LN
Saint Louis, MO 63132-2946
Phone (608) 280-4647

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

1225 S Grand Blvd
Saint Louis, MO 63104-1016

7920 Clayton Rd
Saint Louis, MO 63117-1327
Phone (314) 366-4768

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F07181228MOMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients

Locations

1225 S Grand Blvd
Fl 2
Saint Louis, MO 63104
Phone (314) 617-2355

3691 Rutger St
Saint Louis, MO 63110
Phone (314) 268-4101

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

Interoperability endpoints

  • Direct secure messaging: selliott32274@direct-ehr-ssmhc.com

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 1

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": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1407323132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 S SPRING AVE FL 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102520",
            "telephone_number": "314-977-8462",
            "fax_number": "314-977-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041016",
            "telephone_number": "314-977-8462",
            "fax_number": "314-977-3370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3691 Rutger St",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631102515",
            "country_code": "US",
            "telephone_number": "314-977-6828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "SUSAN",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2018026391",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "F07181228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "selliott32274@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "selliott32274@direct-ehr-ssmhc.com",
            "address_1": "1201 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "http://fhir.ssmhc.com/fhir/api/FHIR/DSTU2?",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1201 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041016",
            "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.