Individual provider Active NPI

Megan Samantha Knetzer, FNP

  • Family Nurse Practitioner
  • O Fallon, IL
National Provider Identifier
1790301232
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209030918 Issued in IL
Practice address
3 Saint Elizabeth Blvd Ste 3900
O Fallon, IL 62269-1282
Phone
(314) 806-1770
Fax
(314) 558-9017
NPI assigned
Jun 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2021018970 MO
Family Nurse Practitioner 363LF0000X 209030918 IL Primary

Addresses

Primary practice location

3 Saint Elizabeth Blvd Ste 3900
O Fallon, IL 62269-1282

Mailing address

12855 N 40 Dr Ste 375
Saint Louis, MO 63141-8657
Phone (314) 806-1770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211230000161 MO Practitioner - Nurse Practitioner 4688065659 Reassigns benefits to 2 organizations
I20241106002609 IL Practitioner - Nurse Practitioner 4688065659 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Signature Medical Group IncGroup PAC ID 4880598291, 40 clinicians
Urology of St Louis IncGroup PAC ID 6204723786, 112 clinicians
Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Practice addresses (Care Compare)

12639 Old Tesson Rd
Suite 115
Saint Louis, MO 63128-2786
Phone 31484903112384

12855 N 40 Dr
125 Neurosurgery of St Louis
Saint Louis, MO 63141-8663
Phone (314) 806-1770

6812 State Route 162 200
Maryville, IL 62062-8562
Phone (618) 288-0900

6828 State Route 162
Suite a
Maryville, IL 62062-8558
Phone (618) 391-5380

Hospital & facility affiliations

  • HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187
  • Anderson Hospital Hospital, Maryville, IL, CCN 140289
  • St Josephs Hospital Hospital, Breese, IL, CCN 140145
  • Hillsboro Area Hospital Hospital, Hillsboro, IL, CCN 141332
  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209030918ILMDAdult Health Nurse Practitioner
2021018970MOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urology of St. Louis, Inc. CurrentSince Oct 3, 2024 Accepting new patients
Signature Medical Group, Inc CurrentSince Aug 1, 2022 Accepting new patients
Urology of St. Louis, Inc. CurrentSince Oct 3, 2024 Accepting new patients
Anderson Medical Group, LLC CurrentSince Oct 24, 2024 Accepting new patients
Signature Medical Group, Inc CurrentSince Aug 1, 2022 Accepting new patients
Urology of St. Louis, Inc. Past Accepting new patients

Locations

6812 State Route 162
Ste 200
Maryville, IL 62062
Phone (618) 288-0900

6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405

6828 State Route 162
Ste A
Maryville, IL 62062
Phone (618) 288-8363

3 Saint Elizabeth Blvd
Ste 3900
O Fallon, IL 62269
Phone (314) 806-1770

12639 Old Tesson Rd
Ste 115
Saint Louis, MO 63128
Phone (314) 842-8655

12639 Old Tesson Rd
Saint Louis, MO 63128
Phone (314) 446-0291

12855 N 40 Dr
Ste 375
Saint Louis, MO 63141

12855 N 40 Dr
Ste 125
Saint Louis, MO 63141
Phone (314) 806-1770

12855 N 40 Dr
Saint Louis, MO 63141
Phone (314) 432-4415

112 Piper Hill Dr
Ste 3
Saint Peters, MO 63376
Phone (314) 806-1770

5301 Veterans Memorial Pkwy
Ste 105
Saint Peters, MO 63376
Phone (314) 806-1770

Interoperability endpoints

  • Direct secure messaging: meganknetzer@slus.allscriptsdirect.net

Organizations & group practices 6

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 8

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": "1592611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1790301232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 375",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418657",
            "telephone_number": "314-806-1770",
            "fax_number": "314-558-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SAINT ELIZABETH BLVD STE 3900",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691282",
            "telephone_number": "314-806-1770",
            "fax_number": "314-558-9017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNETZER",
        "first_name": "MEGAN",
        "middle_name": "SAMANTHA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-20",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021018970",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209030918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

Verify at the official NPI Registry.