Heather M. St. Amour, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

310039 Issued in NY

Practice address

5015 Campuswood Dr
East Syracuse, NY 13057-4232

Phone

(315) 204-0397

NPI assigned

Oct 27, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heather M. Mouton Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: ms_hstamou@landmarkhealth-direct.org

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1700486065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S B B KING BLVD # 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032626",
            "telephone_number": "901-436-1381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 CAMPUSWOOD DR",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130574232",
            "telephone_number": "315-204-0397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. AMOUR",
        "first_name": "HEATHER",
        "middle_name": "M.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700486065",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "MOUTON",
            "middle_name": "M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gussie M Sorensen, LCSW-R
• Tarek J Sousou, MD
• Shannon Barbara Spencer, MD
• Judy Spilka
• Kelsey Spradlin
• Stafkings Healthcare Systems, Inc
• Jeffrey Hunter Standish
• Greg Robert Stanley, RPH
• Kyerra Stanley, DPT
• Deborah Lynn Starczewski, MS.ED

• Adult Health Nurse Practitioner in East Syracuse, NY
• Providers in East Syracuse, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.