Active NPI
Amy Guan, MS, APN
- Gerontology Nurse Practitioner
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 2023012036
- Practice address
- 12348 Old Tesson Rd Ste 250
Saint Louis, MO 63128-2261 - Phone
- (314) 272-2727
- NPI assigned
- Mar 6, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 209016579 | IL | |
| Primary Care Nurse Practitioner | 363LP2300X | 2023014672 | MO | |
| Gerontology Nurse Practitioner | 363LG0600X | 2023012036 | MO | Primary |
Addresses
Primary practice location
12348 Old Tesson Rd Ste 250
Saint Louis, MO 63128-2261
Mailing address
PO Box 776084
Chicago, IL 60677-6084
Phone (314) 272-2727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12348 Old Tesson Rd
Suite 250
Saint Louis, MO 63128-2261
Phone (314) 272-2727
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023012036 | MO | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Community Health Network | Current | Accepting new patients | |
| Access Community Health Network | Current | Accepting new patients | |
| Mercy Clinic East Communities | Current | Accepting new patients | |
| Access Community Health Network | Current | Accepting new patients |
Locations
600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000
4839 W 47th St
Chicago, IL 60638
Phone (773) 735-2345
12348 Old Tesson Rd
Ste 240
Saint Louis, MO 63128
Phone 3144673900 ext. 284
621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335
12348 Old Tesson Rd
Ste 250
Saint Louis, MO 63128
Phone (314) 272-2727
621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1851335228
-
- Federally Qualified Health Center (FQHC)
- Des Plaines, IL
- NPI 1982783692
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1275605792
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1699701383
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1568481984
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1801398813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 776084",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606776084",
"telephone_number": "314-272-2727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12348 OLD TESSON RD STE 250",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631282261",
"telephone_number": "314-272-2727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUAN",
"first_name": "AMY",
"credential": "MS, APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-06",
"last_updated": "2023-09-11",
"certification_date": "2023-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "IL",
"license": "209016579",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "MO",
"license": "2023014672",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MO",
"license": "2023012036",
"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 Sep 11, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.