Individual provider Active NPI

Sarah Marie Raney, ACNP

  • Acute Care Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1922730753
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2022023159 Issued in MO
Practice address
12700 Southfork Rd Ste 153
Saint Louis, MO 63128-3201
Phone
(314) 543-5283
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2022023159 MO Primary

Addresses

Primary practice location

12700 Southfork Rd Ste 153
Saint Louis, MO 63128-3201

Mailing address

4384 Holly Hills Blvd
Saint Louis, MO 63116-2257
Phone (314) 246-1333

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.eto965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE) Alton Memorial Hospital

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
I20220825001196 MO Practitioner - Nurse Practitioner 9133503188 Reassigns benefits to 2 organizations
I20260515003375 IL Practitioner - Nurse Practitioner 9133503188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gomelb Vascular LLCGroup PAC ID 2668713884, 4 clinicians

Practice addresses (Care Compare)

12855 N 40 Dr
Suite 205
Saint Louis, MO 63141-8670
Phone (314) 255-2204

3 Park PL
Suite a
Swansea, IL 62226-2965
Phone (314) 255-2204

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Pain Management, LLC CurrentSince Aug 22, 2022 Accepting new patients
Gomelb Vascular LLC CurrentSince May 1, 2025 Accepting new patients
Mercy Hospitals East Communities PastSince Jul 3, 2022 Accepting new patients

Locations

3 Park Pl
Ste A
Swansea, IL 62226

3 Park Pl
Swansea, IL 62226
Phone (618) 222-9244

15945 Clayton Rd
Ste 220CLAY
Ballwin, MO 63011
Phone (636) 239-8097

4585 Washington St
Florissant, MO 63033
Phone (314) 921-1129

12700 Southfork Rd
Ste 153
Saint Louis, MO 63128
Phone (314) 543-5283

1028 S Kirkwood Rd
Saint Louis, MO 63122
Phone (314) 394-2255

12855 N 40 Dr
Ste 205
Saint Louis, MO 63141
Phone (314) 720-0900

4173 Crescent Dr
Ste A
Saint Louis, MO 63129
Phone (314) 254-2420

851 E 5th St
Ste 226
Washington, MO 63090
Phone (636) 239-8097

Interoperability endpoints

  • Direct secure messaging: sarah.raney.1@19245.direct.athenahealth.com

Organizations & group practices 3

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1922730753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4384 HOLLY HILLS BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631162257",
            "telephone_number": "314-246-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 153",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-543-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANEY",
        "first_name": "SARAH",
        "middle_name": "MARIE",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2022023159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.eto965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "endpointDescription": "BJC",
            "affiliationName": "Alton Memorial Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Memorial Dr",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620026722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.