Individual provider Active NPI

Amanda Jean Mersman, FNP-C

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1689263667
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2021001527 Issued in MO
Practice address
9556 Manchester Rd
Saint Louis, MO 63119-1313
Phone
(314) 373-5740
NPI assigned
Jan 13, 2021
Last updated
Jul 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209022664 IL
Nurse Practitioner 363L00000X 2021001527 MO Primary

Addresses

Primary practice location

9556 Manchester Rd
Saint Louis, MO 63119-1313

Mailing address

9556 Manchester Rd
Saint Louis, MO 63119-1313
Phone (314) 373-5740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210301000509 IL Practitioner - Nurse Practitioner 8729493614 Reassigns benefits to 5 organizations
I20220222000137 MO Practitioner - Nurse Practitioner 8729493614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tauc Il PCGroup PAC ID 3173060282, 17 clinicians
Total Access Urgent Care PCGroup PAC ID 8820171929, 130 clinicians

Practice addresses (Care Compare)

1103 Central Park Dr
O Fallon, IL 62269-1770
Phone (618) 215-5703

9556 Manchester Rd
Saint Louis, MO 63119-1313
Phone (314) 961-2255

Merit-based Incentive Payment System (MIPS)

Final score
42.87 of 100Reported as group
Quality
31.86
Promoting interoperability
0
Improvement activities
40
Cost
61.04

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alton Urgent Care Walk in Clinic Company CurrentSince Apr 1, 2021 Accepting new patients
Belleville Urgent Care Walk-in Clinic CurrentSince Jan 15, 2021 Accepting new patients
Tauc Il, PC CurrentSince Sep 3, 2024 Accepting new patients
Waterloo Urgent Care Walk in Clinic Company CurrentSince Apr 1, 2021 Accepting new patients
Granite City Urgent Care Walk-in Clinic CurrentSince Jan 15, 2021 Accepting new patients
Total Access Urgent Care, PC CurrentSince Feb 10, 2022 Accepting new patients
Total Access Urgent Care, PC CurrentSince Feb 10, 2022 Accepting new patients

Locations (25 of 33)

1417 Washington Ave
Alton, IL 62002
Phone (618) 260-0320

2801 W Main St
Belleville, IL 62226
Phone (618) 234-3053

400 Belt Line Rd
Collinsville, IL 62234
Phone (618) 215-5703

404 Belt Line Rd
Collinsville, IL 62234
Phone (618) 215-5703

2861 Madison Ave
Granite City, IL 62040
Phone (618) 709-7723

1103 Central Park Dr
O Fallon, IL 62269
Phone (618) 215-5703

907 N Illinois Route 3
Waterloo, IL 62298
Phone (618) 350-0200

14671 Telegraph Rd
Redford, MI 48239
Phone (313) 387-2100

9538 Gravois Rd
Affton, MO 63123
Phone (314) 932-0817

12409 Saint Charles Rock Rd
Bridgeton, MO 63044
Phone (314) 455-4046

2501 Clarkson Rd
Chesterfield, MO 63017
Phone (636) 778-9989

10923 Olive Blvd
Creve Coeur, MO 63141
Phone (314) 764-8359

408 Brothers Dr
Festus, MO 63028
Phone (636) 429-0999

1090 N Highway 67 St
Florissant, MO 63031

915 N Kirkwood Rd
Kirkwood, MO 63122
Phone (314) 932-0810

1001 Southern Ridge Ln
Lake Saint Louis, MO 63367
Phone (636) 265-6230

4201 Highway K
O Fallon, MO 63368

507 S Main St
O Fallon, MO 63366
Phone (636) 409-1092

8961 Page Ave
Overland, MO 63114

2138 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 534-4498

1005 S Big Bend Blvd
Saint Louis, MO 63117
Phone (314) 449-8677

12616 Lamplighter Square Shpg Ctr
Saint Louis, MO 63128

2060 Hampton Ave
Saint Louis, MO 63139
Phone (314) 696-2341

2980 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (636) 529-8411

3114 S Grand Blvd
Saint Louis, MO 63118

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, 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": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1689263667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9556 MANCHESTER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631191313",
            "telephone_number": "314-373-5740",
            "fax_number": "314-373-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9556 MANCHESTER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631191313",
            "telephone_number": "314-373-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERSMAN",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2022-07-06",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209022664",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2021001527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.