Jeanetta Stomer

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2004029626 Issued in MO

Practice address

3391 N Highway 67
Florissant, MO 63033-1604

Phone

(314) 736-1146

NPI assigned

Dec 1, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Agans Medical LLCGroup PAC ID 9830557875, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Mary's Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jstomer13371@direct-ehr-ssmhc.com

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.

• Agans Medical LLC

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Saint Louis, MO
  • NPI 1437843240
  Medicare reassignment Care Compare group
• NP Health Information Station LLC

  • Adult Health Nurse Practitioner
  • Florissant, MO
  • NPI 1184116014
  Medicare reassignment Authorized official
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  MO

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SSM Health Care St. Louis

  dba SSM Health Cardinal Glennon Children's Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1336387836
  Care Compare affiliation
• SSM Health Care St. Louis

  dba SSM Health St. Mary's Hospital - St. Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1962572396
  Care Compare affiliation

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

{
    "created_epoch": "1480550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585353600000",
    "number": "1609319144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3391 N HIGHWAY 67",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630331604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3391 N HIGHWAY 67",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630331604",
            "telephone_number": "314-736-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOMER",
        "first_name": "JEANETTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-01",
        "last_updated": "2020-03-28",
        "certification_date": "2020-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2004029626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Eric Stickel, OD
• Cody Adam Stieglitz
• Still Care Assisted Living LLC
• STL Mid County Dental LLC (Florissant Dental Services)
• Tatiana Stocking
• Robert H Strashun, MD
• Jessica Rae Strassner, MSW, LCSW
• William Arvil Straughn III, DC
• Strength & Patience Healthcare, LLC
• Amber Strick

• Family Nurse Practitioner in Florissant, MO
• Providers in Florissant, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.