Individual provider Active NPI

Mary G Epperson, PNP

  • Pediatric Nurse Practitioner
  • Chesterfield, MO
National Provider Identifier
1588095590
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
103040 Issued in MO
Practice address
13001 N Outer 40 Rd
Div Neurology Pediatrics, Ste 1a
Chesterfield, MO 63017-5941
Phone
(314) 454-6120
Fax
(314) 454-4225
NPI assigned
Dec 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 103040 MO Primary

Addresses

Primary practice location

13001 N Outer 40 Rd
Div Neurology Pediatrics, Ste 1a
Chesterfield, MO 63017-5941

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 454-6120

Other identifiers 1

IdentifierTypeStateIssuer
420011576MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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
I20160108001660 MO Practitioner - Nurse Practitioner 6002118973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Nov 16, 2015 Accepting new patients
Washington University CurrentSince Nov 16, 2015 Accepting new patients
Washington University Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

13001 North Outer 40 Rd
Ste 1A
Chesterfield, MO 63017
Phone (314) 454-6120

4455 Duncan Ave
Saint Louis, MO 63110
Phone (314) 658-3800

660 S Euclid Ave
#C
Saint Louis, MO 63110

5114 Mid America Plz
Ste 3A
Saint Louis, MO 63129
Phone (314) 454-6120

1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076

660 S Euclid Ave
#8111
Saint Louis, MO 63110
Phone (314) 362-3281

13001 North Outer 40 Rd
Town and Country, MO 63017
Phone (314) 454-3013

Organizations & group practices 4

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": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1588095590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-454-6120",
            "fax_number": "314-454-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13001 N OUTER 40 RD",
            "address_2": "DIV NEUROLOGY PEDIATRICS, STE 1A",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175941",
            "telephone_number": "314-454-6120",
            "fax_number": "314-454-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPERSON",
        "first_name": "MARY",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-02",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "103040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420011576",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "13001 N Outer 40 Rd",
            "address_2": "Div Neurology Pediatrics, Ste 1A",
            "city": "Chesterfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630175941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.