Individual provider Active NPI

Katie Haas, FNP-BC

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1912558446
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2019037093 Issued in MO
Practice address
30 Ronnies PLZ
Saint Louis, MO 63126-3552
Phone
(314) 989-6807
NPI assigned
Sep 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2019037093 MO Primary
Nurse Practitioner 363L00000X 2019037093 MO

Addresses

Primary practice location

30 Ronnies PLZ
Saint Louis, MO 63126-3552

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534

Other practice location 1

3920 Hampton Ave
Saint Louis, MO 63109-1401
Phone (314) 687-2713

Other practice location 2

14021 New Halls Ferry Rd
Florissant, MO 63033-2708
Phone (314) 839-9053

Other names 1

  • Katie Dulle Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address khaase275925@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200224000246 MO Practitioner - Nurse Practitioner 5991132409 Reassigns benefits to 2 organizations
I20260504005956 IL Practitioner - Nurse Practitioner 5991132409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NP Health of Mo LLCGroup PAC ID 4183047053, 17 clinicians
Physiatry Consultants of NC PLLCGroup PAC ID 2567871643, 77 clinicians

Practice addresses (Care Compare)

1201 Garden Plaza Dr
Florissant, MO 63033-2230
Phone (314) 831-3752

4315 Memorial Dr
Belleville, IL 62226-5342
Phone (618) 619-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019037093MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NP Health of Mo LLC CurrentSince Dec 30, 2025 Accepting new patients
SSM Health Care St Louis CurrentSince Nov 1, 2020 Accepting new patients
SSM Health Care St. Louis CurrentSince Nov 1, 2020 Accepting new patients

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

4401 Parker Rd
Black Jack, MO 63033
Phone (314) 312-0720

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1201 Garden Plaza Dr
Florissant, MO 63033
Phone (314) 831-3752

14021 New Halls Ferry Rd
Florissant, MO 63033
Phone (314) 839-0910

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

Interoperability endpoints

  • Direct secure messaging: khaase275925@direct-ehr-ssmhc.com

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": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1912558446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 RONNIES PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631263552",
            "telephone_number": "314-989-6807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3920 Hampton Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631091401",
            "country_code": "US",
            "telephone_number": "314-687-2713",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14021 New Halls Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Florissant",
            "state": "MO",
            "postal_code": "630332708",
            "country_code": "US",
            "telephone_number": "314-839-9053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAAS",
        "first_name": "KATIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019037093",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2019037093",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khaase275925@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "khaase275925@direct-ehr-ssmhc.com",
            "address_1": "30 Ronnies Plz",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631263552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "30 Ronnies Plz",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631263552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "DULLE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.