NPIMap

Individual provider Active NPI

Mindy Kay Wortmann, NP

  • Nurse Practitioner
  • Festus, MO
National Provider Identifier
1962993584
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2018030076 Issued in MO
Practice address
1405 N Truman Blvd
Festus, MO 63028-1177
Phone
(636) 933-2243
Fax
(636) 933-2252
NPI assigned
May 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2018030076 MO Primary

Addresses

Primary practice location

1405 N Truman Blvd
Festus, MO 63028-1177

Mailing address

PO Box 3891
Chesterfield, MO 63006-3891
Phone (636) 933-2243

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mindy.wortmann@ipi.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181019000741 MO Practitioner - Nurse Practitioner 7315290467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interventional Pain Institute, LLCGroup PAC ID 1153451919, 9 clinicians
Physical Therapy Spine and Sports Medicine LLCGroup PAC ID 3173654936, 123 clinicians

Practice addresses (Care Compare)

1405 N Truman Blvd
Festus, MO 63028-1177
Phone (636) 933-2243

15425 Manchester Rd
Suite 28
Ballwin, MO 63011-3077
Phone (636) 220-6969

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
  • Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Merit-based Incentive Payment System (MIPS)

Final score
35.25 of 100Reported as individual
Quality
36.67
Improvement activities
0
Cost
64.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018030076MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Institute, LLC CurrentSince Aug 27, 2018 Accepting new patients
Interventional Pain Institute, LLC CurrentSince Aug 27, 2018 Accepting new patients
Key Anesthesia Partners PastSince Apr 15, 2020 Accepting new patients
Dreamy Time Inc PastSince Oct 1, 2021 Accepting new patients
Interventional Pain Center of Chesterfield LLC Past Accepting new patients

Locations

500 Chesterfield Ctr
Ste 250
Chesterfield, MO 63017
Phone (636) 519-8889

17300 North Outer 40 Rd
Ste 100
Chesterfield, MO 63005
Phone (314) 865-7992

1405 N Truman Blvd
Festus, MO 63028
Phone (314) 432-2329

721 S 5th St
Saint Charles, MO 63301

60 Business Park Dr
Ste A
Troy, MO 63379
Phone (636) 728-9460

Organizations & group practices 7

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 7

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": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1962993584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3891",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630063891",
            "telephone_number": "636-933-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 N TRUMAN BLVD",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281177",
            "telephone_number": "636-933-2243",
            "fax_number": "636-933-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTMANN",
        "first_name": "MINDY",
        "middle_name": "KAY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2018030076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mindy.wortmann@ipi.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1405 N Truman Blvd",
            "city": "Festus",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630281177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.