Vickie Joann Carll, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

109547 Issued in MO

Practice address

6420 Clayton Rd
Saint Louis, MO 63117-1811

Phone

(314) 317-0600

Fax

(314) 317-0606

NPI assigned

Jul 13, 2006

Last updated

Aug 15, 2013By the provider in NPPES

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

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

Specialty

Nurse Practitioner

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sound Physicians of Illinois LLCGroup PAC ID 1557533734, 193 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
• SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Sound Physicians of Illinois, LLC

  • Hospitalist Physician
  • Bridgeton, MO
  • NPI 1043598865
  Medicare reassignment Care Compare group NPD
• Cep America, LLC

  dba Vituity

  • Emergency Medicine Physician
  • Saint Louis, MO
  • NPI 1619332046
  Medicare reassignment NPD
• Cogent Healthcare of Missouri, Inc

  • Critical Care Medicine (Internal Medicine) Physician
  • Fenton, MO
  • NPI 1780961599
  Medicare reassignment NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  MO

  Medicare reassignment NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Richmond Heights, MO
  • NPI 1942855366
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Inpatient Consultants of Missouri Inc

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1194779579
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SSM Health Care St. Louis

  dba SSM Health St. Joseph Hospital - St. Charles

  • General Acute Care Hospital
  • Saint Charles, MO
  • NPI 1467521146
  Care Compare affiliation
• SSM Health Care St. Louis

  dba SSM Health St Joseph Hospital - Lake Saint Louis

  • General Acute Care Hospital
  • Lake St Louis, MO
  • NPI 1871665380
  Care Compare affiliation

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1710902176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12125 WOODCREST EXECUTIVE DR",
            "address_2": "SUITE 220",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415001",
            "telephone_number": "314-317-0600",
            "fax_number": "314-317-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-317-0600",
            "fax_number": "314-317-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLL",
        "first_name": "VICKIE",
        "middle_name": "JOANN",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "109547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710902176",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carla Tellor Grundy
• Carol Carlberg
• Jeffrey Ray Carley, MD
• Bridget Caitlyn Carlile, SLP
• Abigail A Carlisle
• Timothy John Carlock, RN
• Amy Carlson, AUD
• Ellen Claire Carlson, AGNP
• Jacob Larry Carlson, CRNA
• Jon Brandon Carlson, M.D.

• Adult Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.