Individual provider Active NPI

Gina Marie Schnurbusch, FNP

  • Family Nurse Practitioner
  • O Fallon, MO
National Provider Identifier
1861928244
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016004339 Issued in MO
Practice address
5551 Winghaven Blvd Ste 290
O Fallon, MO 63368-3629
Phone
(636) 695-2575
Fax
(314) 590-5938
NPI assigned
May 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016004339 MO Primary

Addresses

Primary practice location

5551 Winghaven Blvd Ste 290
O Fallon, MO 63368-3629

Mailing address

426 Morningside Dr
Saint Peters, MO 63376-4003
Phone (314) 220-2455

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
I20170623000361 MO Practitioner - Nurse Practitioner 7315215902 Reassigns benefits to 1 organization

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
Internal Medicine at Winghaven, LLCGroup PAC ID 6406018605, 3 clinicians
Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

5551 Winghaven Blvd
Suite 290
O Fallon, MO 63368-3629
Phone (636) 695-2575

7212 Balson Ave
Saint Louis, MO 63130-3001

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine at Winghaven, LLC CurrentSince Jan 28, 2019 Accepting new patients
Internal Medicine at Winghaven LLC Current Accepting new patients
St. Lukes Medical Group Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

5551 Winghaven Blvd
Ste 290
O Fallon, MO 63368
Phone (636) 561-6011

Organizations & group practices 5

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": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1861928244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 MORNINGSIDE DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633764003",
            "telephone_number": "314-220-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5551 WINGHAVEN BLVD STE 290",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633683629",
            "telephone_number": "636-695-2575",
            "fax_number": "314-590-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNURBUSCH",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-04",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016004339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

Verify at the official NPI Registry.