Individual provider Active NPI

Molly M Twellman, ANP

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1750776100
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2015009936 Issued in MO
Practice address
10012 Kennerly Rd
Suite 403
Saint Louis, MO 63128-2197
Phone
(314) 880-6676
Fax
(314) 842-4372
NPI assigned
Apr 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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 2015009936 MO Primary

Addresses

Primary practice location

10012 Kennerly Rd
Suite 403
Saint Louis, MO 63128-2197

Mailing address

10012 Kennerly Rd
Suite 403
Saint Louis, MO 63128-2197
Phone (314) 880-6676

Other names 1

  • Miss Molly M Weber Former name

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
I20150526000666 MO Practitioner - Nurse Practitioner 6709106222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Cardiovascular and Thoracic Surgery LLCGroup PAC ID 6204832199, 23 clinicians

Practice addresses (Care Compare)

10012 Kennerly Rd
Suite 101
Saint Louis, MO 63128-2197
Phone (314) 880-6676

625 S New Ballas Rd
R 7040
Saint Louis, MO 63141-8253
Phone (314) 251-6970

Hospital & facility affiliations

  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Cardiovascular and Thoracic Surgery, LLC CurrentSince Jan 1, 2020 Accepting new patients
Mercy Clinic Cardiovascular and Thoracic Surgery, LLC CurrentSince Jan 1, 2020 Accepting new patients

Locations

10012 Kennerly Rd
Ste 300
Saint Louis, MO 63128
Phone (314) 842-0602

625 S New Ballas Rd
Ste R7040
Saint Louis, MO 63141
Phone (314) 251-5756

10012 Kennerly Rd
Ste 403
Saint Louis, MO 63128
Phone (314) 525-1800

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

625 S New Ballas Rd
#R7040
Saint Louis, MO 63141

10012 Kennerly Rd
Ste 101
Saint Louis, MO 63128
Phone (314) 525-4325

10012 Kennerly Rd
Ste 305
Saint Louis, MO 63128
Phone (314) 525-4325

Interoperability endpoints

  • Direct secure messaging: mtwellman992389@directc.mercy.net

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1750776100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD",
            "address_2": "SUITE 403",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-880-6676",
            "fax_number": "314-842-4372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD",
            "address_2": "SUITE 403",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-880-6676",
            "fax_number": "314-842-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWELLMAN",
        "first_name": "MOLLY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2015009936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "WEBER",
            "middle_name": "M",
            "prefix": "MISS",
            "credential": "ANP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.