Individual provider Active NPI

Lea-Ana Rae Hodges, AGNP-BC

  • Adult Health Nurse Practitioner
  • St. Louis, MO
National Provider Identifier
1831632165
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2016041030 Issued in MO
Practice address
10345 Watson Road
St. Louis, MO 63127
Phone
(314) 384-3584
Fax
(314) 965-6067
NPI assigned
Nov 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2016041030 MO Primary

Addresses

Primary practice location

10345 Watson Road
St. Louis, MO 63127

Mailing address

10345 Watson Road
St. Louis, MO 63127
Phone (314) 384-3584

Other identifiers 1

IdentifierTypeStateIssuer
420074643MedicaidMO

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171207002181 MO Practitioner - Nurse Practitioner 8921365743 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Physician Group Missouri LLCGroup PAC ID 4082958574, 18 clinicians

Practice addresses (Care Compare)

12380 Depaul Dr
Bridgeton, MO 63044-2511
Phone (314) 447-9700

4455 Duncan Ave
Saint Louis, MO 63110-1111
Phone 31465838004154

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016041030MOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Jan 1, 2020 Accepting new patients
McPherson Medical & Diagnostic, LLC CurrentSince Oct 1, 2023 Accepting new patients
Mercy Clinic East Communities CurrentSince Jan 1, 2020 Accepting new patients
McPherson Medical & Diagnostic, LLC Current Accepting new patients
McPherson Medical & Diagnostic, LLC CurrentSince Oct 1, 2023 Accepting new patients
Impact Physician Group, Missouri, LLC CurrentSince Feb 17, 2025 Accepting new patients
McPherson Medical & Diagnostic, LLC Past Accepting new patients
Arnold Family Medicine LLC PastSince Jun 1, 2011 Accepting new patients

Locations

3619 Richardson Square Dr
Ste 170
Arnold, MO 63010
Phone (636) 717-6776

1717 Catlin Dr
Barnhart, MO 63012
Phone (636) 741-3233

10004 Kennerly Rd
Ste 186B
Saint Louis, MO 63128
Phone (314) 543-5969

4455 Duncan Ave
Saint Louis, MO 63110
Phone (314) 658-3800

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

10345 Watson Rd
Saint Louis, MO 63127
Phone (314) 384-3584

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

12700 Southfork Rd
Ste 280
Saint Louis, MO 63128
Phone (314) 525-4990

216 W Main St
Ste B
Steele, MO 63877
Phone (573) 695-2181

216 W Main St
Steele, MO 63877
Phone (573) 695-2181

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GGJGAA

Organizations & group practices 8

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 1

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": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1831632165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10345 WATSON ROAD",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63127",
            "telephone_number": "314-384-3584",
            "fax_number": "314-965-6067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10345 WATSON ROAD",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63127",
            "telephone_number": "314-384-3584",
            "fax_number": "314-965-6067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "LEA-ANA",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "AGNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-17",
        "last_updated": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2016041030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420074643",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Louis, MO

Sources for this page

Verify at the official NPI Registry.