Individual provider Active NPI

Mary B Ernst, FNP

  • Nurse Practitioner
  • Saint Peters, MO
National Provider Identifier
1487694659
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2014010124 Issued in MO
Practice address
107 Piper Hill Dr
Saint Peters, MO 63376-1620
Phone
(636) 477-8757
Fax
(314) 219-6241
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2014010124 MO
Acute Care Nurse Practitioner 363LA2100X 073032 MO
Nurse Practitioner 363L00000X 2014010124 MO Primary

Addresses

Primary practice location

107 Piper Hill Dr
Saint Peters, MO 63376-1620

Mailing address

107 Piper Hill Dr
Saint Peters, MO 63376-1620
Phone (636) 477-8757

Other practice location 1

1520 Wentzville Pkwy
Wentzville, MO 63385-3408
Phone (636) 497-4060

Other identifiers 1

IdentifierTypeStateIssuer
81828OtherMOPROVIDER NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20040217001161 MO Practitioner - Nurse Practitioner 9133014293 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

1520 Wentzville Pkwy
Wentzville, MO 63385-3408
Phone (636) 497-4000

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
073032MOMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC CurrentSince May 1, 2022 Accepting new patients
St Louis Pathology Assoc Inc. Current Accepting new patients
Mercy Hospitals East Communities CurrentSince Mar 9, 2014 Accepting new patients
Physician Groups LC CurrentSince May 1, 2022 Accepting new patients
Mercy Hospitals East Communities CurrentSince Mar 9, 2014 Accepting new patients
Mercy Clinic East Communities Past Accepting new patients

Locations

17701 Edison Ave
Ste 101
Chesterfield, MO 63005
Phone (636) 735-4122

637 Dunn Rd
Ste 102
Hazelwood, MO 63042
Phone (314) 731-3111

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

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

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

107 Piper Hill Dr
Saint Peters, MO 63376
Phone (636) 477-8757

1520 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 497-4000

Organizations & group practices 6

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1487694659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 PIPER HILL DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761620",
            "telephone_number": "636-477-8757",
            "fax_number": "314-219-6241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 PIPER HILL DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761620",
            "telephone_number": "636-477-8757",
            "fax_number": "314-219-6241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 Wentzville Pkwy",
            "address_purpose": "LOCATION",
            "city": "Wentzville",
            "state": "MO",
            "postal_code": "633853408",
            "country_code": "US",
            "telephone_number": "636-497-4060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERNST",
        "first_name": "MARY",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2014010124",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "073032",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2014010124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "81828",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 Wentzville Pkwy",
            "city": "Wentzville",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633853408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.