Individual provider Active NPI

Susan J Hofmann, ANP

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1780001446
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2014008352 Issued in MO
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

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
2014008352MOMDAdult 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.

Verify at the official NPI Registry.