Active NPI
Mia Glover, FNP-C
- Family Nurse Practitioner
- Arnold, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2015044717
- Practice address
- 3619 Richardson Square Dr
Arnold, MO 63010-6022 - Phone
- (636) 717-6700
- NPI assigned
- Feb 2, 2016
- Last updated
- Aug 18, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2015044717 | MO | Primary |
Addresses
Primary practice location
3619 Richardson Square Dr
Arnold, MO 63010-6022
Mailing address
PO Box 776084
Chicago, IL 60677-6084
Phone (314) 364-4200
Other practice location 1
2991 Highway K # 6
O Fallon, MO 63368-7862
Phone (636) 435-2333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2991 Hwy K
O Fallon, MO 63368-7862
Phone (636) 435-2333
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy East Ambulatory Services LLC | Current | Accepting new patients |
Locations
714 Gravois Rd
Ste 100
Fenton, MO 63026
Phone (636) 326-6100
409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764
2991 Highway K
O Fallon, MO 63368
Phone (636) 435-2333
2991 Highway K
#6
O Fallon, MO 63368
Phone (636) 435-2333
901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Mercy-GoHealth Urgent Care
- Urgent Care Clinic/Center
- Chesterfield, MO
- NPI 1134673148
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692316800000",
"number": "1821456112",
"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": "314-364-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3619 RICHARDSON SQUARE DR",
"city": "ARNOLD",
"state": "MO",
"postal_code": "630106022",
"telephone_number": "636-717-6700"
}
],
"practiceLocations": [
{
"address_1": "2991 Highway K # 6",
"address_purpose": "LOCATION",
"city": "O Fallon",
"state": "MO",
"postal_code": "633687862",
"country_code": "US",
"telephone_number": "636-435-2333",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GLOVER",
"first_name": "MIA",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-02",
"last_updated": "2023-08-18",
"certification_date": "2023-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2015044717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Arnold, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.