STEPHANIE NELLESEN (FNP) – Family Nurse Practitioner, NPI 1003362021

STEPHANIE NELLESEN (FNP) is a healthcare provider. based in Saint louis, Missouri. specializing in Family Nurse Practitioner. They hold the professional credentials FNP. They hold a License No. 2016022548 (MO). The NPI Number for STEPHANIE NELLESEN (FNP) is 1003362021

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
STEPHANIE NELLESEN (FNP)
NPI
1003362021
Phone
(314) 251-6335
Address
621 S NEW BALLAS RD STE 189A
Enumeration Date
30 August 2016
Last Update Date
16 November 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3142516335
Graduation Year
2016 (10 years ago)
PAC ID
6901182310
Group Practice PAC ID
7214827922
Professional Enrollment ID
I20170420000870
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

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Provider Addresses for STEPHANIE NELLESEN (FNP)

  • 189, South New Ballas Road, Creve Coeur, Saint Louis County, Missouri, 63141, United States

    SAINT LOUIS, MO 631418255

    Phone: (314) 251-6335

    Fax: (314) 251-5864

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $21.

Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.

Last reported payment date: 2023-08-31 • Largest payer in this snapshot: ABBVIE INC. ($21).

Total Amount

$21

General + Research + Ownership

Payments

1

Total payment records

General Amount

$21

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-31

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$21
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-04-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170420000870INurse PractitionerMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63141)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7214827922View full group profile
NameSpecialtyState
Internal MedicineMO
Nurse PractitionerMO
-MO
-IL
-MO
O B S T E T R I C S/ G Y N E C O L O G YMO
Physical Medicine And RehabilitationMO
-MO
Nurse PractitionerMO
Nurse PractitionerMO

Reviews

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Frequently asked questions

What NPI should I save for STEPHANIE NELLESEN (FNP)?
Save NPI 1003362021 if you need a stable reference for STEPHANIE NELLESEN (FNP).
Is STEPHANIE NELLESEN (FNP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does STEPHANIE NELLESEN (FNP) list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for STEPHANIE NELLESEN (FNP). Clinical services aligned with this taxonomy classification.
What location shows for STEPHANIE NELLESEN (FNP)?
We surface Saint Louis, Missouri for STEPHANIE NELLESEN (FNP) based on available NPPES addresses.
How can I contact STEPHANIE NELLESEN (FNP)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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