Individual provider Active NPI

Belma Mahmutovic, FNP-BC

  • Family Nurse Practitioner
  • Creve Coeur, MO
National Provider Identifier
1447839436
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2020041035 Issued in MO
Practice address
11560 Olive Blvd
Creve Coeur, MO 63141-7111
Phone
(314) 892-8352
NPI assigned
Apr 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2020041035 MO Primary

Addresses

Primary practice location

11560 Olive Blvd
Creve Coeur, MO 63141-7111

Mailing address

11560 Olive Blvd
Creve Coeur, MO 63141-7111
Phone (866) 387-2727

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
I20210614000400 MO Practitioner - Nurse Practitioner 3274933262 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020041035MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince May 15, 2023 Accepting new patients
Mercy Aco Clinical Services Inc CurrentSince Apr 14, 2024 Accepting new patients
Mercy Clinic East Communities CurrentSince May 15, 2023 Accepting new patients

Locations

15740 South Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 735-4268

12700 Southfork Rd
Ste 200
Saint Louis, MO 63128
Phone (314) 525-4971

12700 Southfork Rd
Ste 220
Saint Louis, MO 63128
Phone (314) 525-1200

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

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.

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1447839436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11560 OLIVE BLVD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417111",
            "telephone_number": "866-387-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11560 OLIVE BLVD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417111",
            "telephone_number": "314-892-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMUTOVIC",
        "first_name": "BELMA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020041035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

Verify at the official NPI Registry.