Rose Mattli, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

143329 Issued in MO

Practice address

456 N New Ballas Rd Ste 348
Creve Coeur, MO 63141-6846

Phone

(314) 548-0265

Fax

(314) 548-6555

NPI assigned

Feb 25, 2010

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• St Louis Kidney, LLC

  • Nephrology Physician
  • Creve Coeur, MO
  • NPI 1730593757
  NPD

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

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1760704290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78429",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631788429",
            "telephone_number": "314-548-0265",
            "fax_number": "314-548-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 N NEW BALLAS RD STE 348",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416846",
            "telephone_number": "314-548-0265",
            "fax_number": "314-548-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTLI",
        "first_name": "ROSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-25",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "143329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "endpointDescription": "EMR",
            "affiliationName": "Barnes Jewish Hospital",
            "address_1": "1 Barnes-Jewish Hospital Plz",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sara Emma Massie
• Abigail Mather, MS, NCC, LPC
• Allen E Mathieu, PAC,ATC,MS
• Bradley Steven Matthes, DDS
• Matthew Huetter DC PC
• Kathy C. Maupin, M.D.
• Rebecca Aku Mawuenyega, RPH
• Vanessa Susan Mays, O.T
• Kevin Scott Mayse, LPC
• Eddie McCaskill, LPC LCSW NCC

• Nurse Practitioner in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.