Individual provider Active NPI

Susan M Tellini, NP-C

  • Family Nurse Practitioner
  • Chesterfield, MO
National Provider Identifier
1881946358
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2012027797 Issued in MO
Practice address
15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone
(636) 735-4755
Fax
(314) 237-4133
NPI assigned
Oct 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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 2012027797 MO Primary

Addresses

Primary practice location

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004

Mailing address

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone (636) 735-4755

Other identifiers 1

IdentifierTypeStateIssuer
2012027797OtherMOMO STATE BOARD OF NURSING

Other names 1

  • Susan M Stockglausner Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20121102000099 MO Practitioner - Nurse Practitioner 1052561842 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians
Mercy Aco Clinical Services IncGroup PAC ID 6901188572, 159 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

1520 Wentzville Pkwy
Wentzville, MO 63385-3408
Phone (636) 497-4000

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone (636) 237-4200

15838 Fountain Plaza Dr
Suite a
Chesterfield, MO 63017-7469
Phone (314) 996-7272

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC CurrentSince Sep 1, 2020 Accepting new patients
Physician Groups LC CurrentSince Sep 1, 2020 Accepting new patients
Inpatient Consultants of Missouri Inc Past Accepting new patients

Locations

15838 Fountain Plaza Dr
Ste A
Chesterfield, MO 63017
Phone (636) 484-5220

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

1520 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 497-4000

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.

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1881946358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15740 S OUTER 40 RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172004",
            "telephone_number": "636-735-4755",
            "fax_number": "314-237-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15740 S OUTER 40 RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172004",
            "telephone_number": "636-735-4755",
            "fax_number": "314-237-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLINI",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012027797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO STATE BOARD OF NURSING",
            "identifier": "2012027797",
            "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": "15838 Fountain Plaza Dr Ste A",
            "city": "Chesterfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630177469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "STOCKGLAUSNER",
            "middle_name": "M",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.