Individual provider Active NPI

Susan B Buettner-Miller, ANP

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1669412359
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
A0605268 Issued in MO
Practice address
625 S New Ballas Rd
Suite 2030
Saint Louis, MO 63141-8253
Phone
(314) 251-1700
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X A0605268 MO Primary

Addresses

Primary practice location

625 S New Ballas Rd
Suite 2030
Saint Louis, MO 63141-8253

Mailing address

625 S New Ballas Rd
Suite 2030
Saint Louis, MO 63141-8253
Phone (314) 251-1700

Other identifiers 2

IdentifierTypeStateIssuer
427223706MedicaidMO
1669412359OtherNPI

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
I20051107000652 MO Practitioner - Nurse Practitioner 1850319096 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Heart and Vascular LLCGroup PAC ID 8820016207, 112 clinicians

Practice addresses (Care Compare)

10012 Kennerly Rd
Saint Louis, MO 63128-2197

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A0605268MOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Aug 24, 2017 Accepting new patients
Mercy Hospitals East Communities CurrentSince Aug 24, 2017 Accepting new patients
Mercy Clinic Heart and Vascular, LLC CurrentSince May 24, 2009 Accepting new patients
St Louis Pathology Assoc Inc. Current Accepting new patients
Mercy Clinic Cardiovascular and Thoracic Surgery, LLC Past Accepting new patients
Saint Luke'S Physician Group Inc Past Accepting new patients
Mercy Clinic East Communities Past Accepting new patients

Locations

15945 Clayton Rd
Ste 230A
Ballwin, MO 63011
Phone (636) 256-5240

1400 US Highway 61
Ste 250
Crystal Cty, MO 63028
Phone (636) 543-2420

620 Maple Valley Dr
Farmington, MO 63640
Phone (573) 454-2466

1203 Smizer Mill Rd
Ste 102
Fenton, MO 63026
Phone (636) 717-1479

755 Dunn Rd
Ste 160
Hazelwood, MO 63042
Phone (314) 251-1775

509 W 18th St
Hermann, MO 65041
Phone (573) 486-2045

2680 Gravois Rd
High Ridge, MO 63049
Phone (314) 842-0602

440 Hometown Plaza Dr
Owensville, MO 65066
Phone (573) 437-6100

1820 Zumbehl Rd
Ste 120
Saint Charles, MO 63303
Phone (314) 801-5350

625 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-0175

12200 Weber Hill Rd
Ste 100
Saint Louis, MO 63127
Phone (314) 698-2400

12348 Old Tesson Rd
Ste 260
Saint Louis, MO 63128
Phone (314) 251-1777

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

10012 Kennerly Rd
Ste 202
Saint Louis, MO 63128
Phone (314) 692-2807

4280 Mid America Ln
Ste 10
Saint Louis, MO 63129
Phone (314) 692-2807

625 S New Ballas Rd
Ste 2030
Saint Louis, MO 63141
Phone (314) 251-5800

625 S New Ballas Rd
Ste 2015
Saint Louis, MO 63141
Phone (314) 251-1775

1326 S Service Rd W
Ste 30
Sullivan, MO 63080
Phone (314) 543-5999

901 Patients First Dr
#2500
Washington, MO 63090

901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500

901 Patients First Dr
Ste 2500
Washington, MO 63090

Organizations & group practices 7

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1669412359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S NEW BALLAS RD",
            "address_2": "SUITE 2030",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418253",
            "telephone_number": "314-251-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S NEW BALLAS RD",
            "address_2": "SUITE 2030",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418253",
            "telephone_number": "314-251-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUETTNER-MILLER",
        "first_name": "SUSAN",
        "middle_name": "B",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "A0605268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427223706",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1669412359",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.