Stephanie Ann Souris, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2018027615 Issued in MO

Practice address

555 Washington Square Shopping Ctr
Washington, MO 63090-5343

Phone

(636) 390-1777

Fax

(636) 390-1778

NPI assigned

Aug 7, 2018

Last updated

Mar 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy East Ambulatory Services LLCGroup PAC ID 2365739240, 102 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mercy East Ambulatory Services LLC

  dba Mercy-GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Chesterfield, MO
  • NPI 1134673148
  Medicare reassignment Care Compare group NPD
• Mercy Hospitals East Communities

  dba Mercy Hospital St Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Medicare reassignment NPD
• Mercy Hospitals East Communities

  dba Mercy St. Louis Transport Ambulance

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902
  NPD
• Mercy Clinic East Communities

  • Multi-Specialty Clinic/Center
  • Wildwood, MO
  • NPI 1164857397
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1861971368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 WASHINGTON SQUARE SHOPPING CTR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630905343",
            "telephone_number": "636-390-1777",
            "fax_number": "636-390-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 WASHINGTON SQUARE SHOPPING CTR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630905343",
            "telephone_number": "636-390-1777",
            "fax_number": "636-390-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "637 Dunn Rd",
            "address_purpose": "LOCATION",
            "city": "Hazelwood",
            "state": "MO",
            "postal_code": "630421747",
            "country_code": "US",
            "telephone_number": "314-817-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 S Euclid Ave Ste 2710",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101005",
            "country_code": "US",
            "telephone_number": "314-273-4850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOURIS",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018027615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP",
            "identifier": "2018027615",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "425 S Euclid Ave Ste 2710",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda M Smith, MD
• Kenneth B Smith, M.D.
• Melissa Ann Smith, DDS
• Michelle Smith
• Jessica Lynn Sneed, MOTR/L
• Southeast Missouri Community Treatment Center, Inc.
• Eugene C Spilker, DC
• St. Elizabeth Adult Day Care Center, Inc.
• St. John's McAuley Clinic
• St. John's Mercy Support Services

• Family Nurse Practitioner in Washington, MO
• Providers in Washington, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; 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.

Verify at the official NPI Registry.