Individual provider Active NPI

Stella Kulkin Heine, AGNP-C

  • Primary Care Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1922714575
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
2022046449 Issued in MO
Practice address
1225 S Grand Blvd
Saint Louis, MO 63104-1016
Phone
(314) 977-4440
NPI assigned
Jan 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 2022046449 MO Primary

Addresses

Primary practice location

1225 S Grand Blvd
Saint Louis, MO 63104-1016

Mailing address

1008 S Spring Ave
Saint Louis, MO 63110-2520
Phone (314) 977-5060

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
I20230329001016 MO Practitioner - Nurse Practitioner 3476927674 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022046449MOMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Apr 1, 2023 Accepting new patients
SLH Physicians LLC CurrentSince Mar 1, 2023 Accepting new patients
SSM Health Care Group CurrentSince Apr 1, 2023 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients

Locations

2315 Dougherty Ferry Rd
Ste 205
Saint Louis, MO 63122
Phone (314) 821-5002

1225 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-3390

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

1035 Bellevue Ave
Ste 305
Saint Louis, MO 63117
Phone (314) 644-6161

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

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.

Hospital & facility affiliations 3

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": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1922714575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 S SPRING AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102520",
            "telephone_number": "314-977-5060",
            "fax_number": "314-977-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041016",
            "telephone_number": "314-977-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINE",
        "first_name": "STELLA",
        "middle_name": "KULKIN",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2022046449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.