Individual provider Active NPI

Clara B Assi, FNP-BC

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1679945885
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2015031879 Issued in MO
Practice address
10012 Kennerly Rd
Suite 301
Saint Louis, MO 63128-2197
Phone
(314) 729-0088
Fax
(314) 729-3991
NPI assigned
Oct 27, 2015
Last updated
Mar 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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 2015031879 MO Primary

Addresses

Primary practice location

10012 Kennerly Rd
Suite 301
Saint Louis, MO 63128-2197

Mailing address

10012 Kennerly Rd
Suite 301
Saint Louis, MO 63128-2197
Phone (314) 729-0088

Other practice location 1

4625 Lindell Blvd Ste 200
Saint Louis, MO 63108-3725
Phone (866) 949-0108

Other identifiers 1

IdentifierTypeStateIssuer
2015031879OtherMOSTATE LICENSE

Other names 1

  • Clara B Abou Assi Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2015031879MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Cardiology PC PastSince Jul 15, 1994 Accepting new patients
John P Marino MD LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1679945885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD",
            "address_2": "SUITE 301",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-729-0088",
            "fax_number": "314-729-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD",
            "address_2": "SUITE 301",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-729-0088",
            "fax_number": "314-729-3991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4625 Lindell Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631083725",
            "country_code": "US",
            "telephone_number": "866-949-0108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASSI",
        "first_name": "CLARA",
        "middle_name": "B",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-27",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015031879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2015031879",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARA",
            "last_name": "ABOU ASSI",
            "middle_name": "B",
            "credential": "FNP-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.