Active NPI
Susan J Hofmann, ANP
- Adult Health Nurse Practitioner
- Saint Louis, MO
National Provider Identifier
1780001446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 2014008352
- Practice address
- 11155 Dunn Rd Ste 109N
Saint Louis, MO 63136-6148 - Phone
- (314) 953-8799
- NPI assigned
- Mar 19, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 209014838 | IL | |
| Adult Health Nurse Practitioner | 363LA2200X | 2014008352 | MO | Primary |
Addresses
Primary practice location
11155 Dunn Rd Ste 109N
Saint Louis, MO 63136-6148
Mailing address
11155 Dunn Rd Ste 109N
Saint Louis, MO 63136-6148
Phone (314) 953-8799
Other practice location 1
11155 Dunn Rd
Ste 109N
Saint Louis, MO 63136-6150
Phone (314) 953-8799
Other practice location 2
8 Sunset Hills Professional Ctr
Edwardsville, IL 62025-3760
Phone (314) 953-8799
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014008352 | MO | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614816000000",
"number": "1780001446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11155 DUNN RD STE 109N",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631366148",
"telephone_number": "314-953-8799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11155 DUNN RD STE 109N",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631366148",
"telephone_number": "314-953-8799"
}
],
"practiceLocations": [
{
"address_1": "11155 Dunn Rd",
"address_2": "Ste 109N",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631366150",
"country_code": "US",
"telephone_number": "314-953-8799",
"fax_number": "314-953-8798",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8 Sunset Hills Professional Ctr",
"address_purpose": "LOCATION",
"city": "Edwardsville",
"state": "IL",
"postal_code": "620253760",
"country_code": "US",
"telephone_number": "314-953-8799",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOFMANN",
"first_name": "SUSAN",
"middle_name": "J",
"credential": "ANP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-19",
"last_updated": "2021-03-04",
"certification_date": "2021-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "IL",
"license": "209014838",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MO",
"license": "2014008352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.