NPIMap

Individual provider Active NPI

Anissa Wheeler, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Imperial, MO
National Provider Identifier
1467059972
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2020021027 Issued in MO
Practice address
1254 Main St
Imperial, MO 63052-3861
Phone
(636) 741-3130
NPI assigned
Oct 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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 2020021027 MO Primary

Addresses

Primary practice location

1254 Main St
Imperial, MO 63052-3861

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (636) 741-3130

Other practice location 1

10631 Thayer Dr
Saint Louis, MO 63123-6018
Phone (618) 367-1762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220517000695 MO Practitioner - Nurse Practitioner 3072990845 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

1254 Main St
Imperial, MO 63052-3861
Phone (636) 741-3130

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023

Merit-based Incentive Payment System (MIPS)

Final score
98.15 of 100Reported as apm
Quality
88.15
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2020021027MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince May 15, 2022 Accepting new patients
St Louis Pain Center LLC CurrentSince Oct 3, 2023 Accepting new patients
Mercy Clinic East Communities CurrentSince Sep 23, 2024 Accepting new patients
Oakville Health and Rehabilitation Center PC PastSince Mar 15, 2013 Accepting new patients

Locations

1254 Main St
Imperial, MO 63052
Phone (636) 741-3130

2300 Main St
Fl 9
Kansas City, MO 64108
Phone (800) 416-1767

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

4455 Telegraph Rd
Ste 250
Saint Louis, MO 63129
Phone (314) 416-4900

5682 Telegraph Rd
Saint Louis, MO 63129
Phone (314) 846-2100

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

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 9

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 4

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": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1467059972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "636-741-3130",
            "fax_number": "636-741-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1254 MAIN ST",
            "city": "IMPERIAL",
            "state": "MO",
            "postal_code": "630523861",
            "telephone_number": "636-741-3130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10631 Thayer Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631236018",
            "country_code": "US",
            "telephone_number": "618-367-1762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "ANISSA",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020021027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Imperial, MO

Sources for this page

Verify at the official NPI Registry.