Individual provider Active NPI

Emily Yvonne Boles Sallade, DNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1649024902
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2024013302 Issued in MO
Practice address
2117 Hillsgate CT
Saint Louis, MO 63146-2210
Phone
(636) 448-5733
NPI assigned
Apr 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 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 2024013302 MO Primary

Addresses

Primary practice location

2117 Hillsgate CT
Saint Louis, MO 63146-2210

Mailing address

2117 Hillsgate CT
Saint Louis, MO 63146-2210
Phone (636) 448-5733

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
I20251211000798 MO Practitioner - Nurse Practitioner 7810481439 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2117 Hillsgate CT
Saint Louis, MO 63146-2210

831 Bedford Ave
Suite 530
Brooklyn, NY 11205-2801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2024013302MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri Mso LLC CurrentSince Oct 5, 2025 Accepting new patients

Locations

1501 Charbonier Rd
Florissant, MO 63031
Phone (314) 921-2700

Organizations & group practices 2

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": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1649024902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 HILLSGATE CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631462210",
            "telephone_number": "636-448-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 HILLSGATE CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631462210",
            "telephone_number": "636-448-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALLADE",
        "first_name": "EMILY",
        "middle_name": "YVONNE BOLES",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2024013302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.