Individual provider Active NPI

Secil Schodroski, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1508278730
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2014014296 Issued in MO
Practice address
9717 Landmark Parkway Dr Ste 115
Saint Louis, MO 63127-1662
Phone
(314) 722-6555
Fax
(314) 722-6551
NPI assigned
May 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 2014014296 MO
Medical-Surgical Registered Nurse 163WM0705X 2006032413 MO
Family Nurse Practitioner 363LF0000X 2014014296 MO Primary

Addresses

Primary practice location

9717 Landmark Parkway Dr Ste 115
Saint Louis, MO 63127-1662

Mailing address

9717 Landmark Parkway Dr Ste 115
Saint Louis, MO 63127-1662
Phone (636) 795-9536

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
I20140826000329 MO Practitioner - Nurse Practitioner 3375761893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Health and Wellness Centerr LLCGroup PAC ID 0143564625, 2 clinicians

Practice addresses (Care Compare)

9717 Landmark Pkwy Dr
Suite 115
Saint Louis, MO 63127-1662
Phone (314) 722-6555

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006032413MOMDMedical-Surgical Registered Nurse
2014014296MOMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Health & Wellness Centerr LLC Primary Care CurrentSince Sep 1, 2015 Accepting new patients
Lea Helen'S Helping Hands for Supportive Care, LLC Current Accepting new patients
Doctors on the Go1 L.C PastSince Jul 2, 2017 Accepting new patients

Locations

9717 Landmark Parkway Dr
Ste 115
Saint Louis, MO 63127
Phone (314) 722-6555

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": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1508278730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9717 LANDMARK PARKWAY DR STE 115",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271662",
            "telephone_number": "636-795-9536",
            "fax_number": "314-722-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9717 LANDMARK PARKWAY DR STE 115",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271662",
            "telephone_number": "314-722-6555",
            "fax_number": "314-722-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHODROSKI",
        "first_name": "SECIL",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2014014296",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MO",
            "license": "2006032413",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2014014296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.