Overview
Roman Hailu is a Nurse Practitioner practicing in Bridgeton, Missouri. The National Provider Identifier (NPI) is #1538413794, which was assigned on November 8, 2012, and the registration record was last updated on November 10, 2020. The practitioner's main practice location is at 12345 Saint Charles Rock Rd, Bridgeton, MO 63044-2505; the contact telephone number is 6462660910. The primary taxonomy of Roman Hailu is Nurse Practitioner (363L00000X). Roman Hailu is licensed to practice in the state of Minnesota (#R 206334-6), Missouri (#2014024606).
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Provider Information
| NPI | 1538413794 |
| Entity Type | Individual |
| Provider Name | ROMAN HAILU |
| Gender | Female |
| Credential | FNP |
| Practice Address | 12345 Saint Charles Rock Rd Bridgeton MO 63044-2505 |
| Practice Telephone | 6462660910 |
| Mailing Address | Po Box 955534 Saint Louis MO 63195-5534 |
| Certification Date | 2020-11-10 |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2020-11-10 |
| Is Sole Proprietor | Y |
Doctor and Clinician Information
| PAC ID | 6709039951Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID |
| Full Name | ROMAN HAILU |
| Primary Specialty | NURSE PRACTITIONER |
| Organization Legal Name | SSM MEDICAL GROUP INC |
| Address | 12345 St Charls Rck Rd Bridgeton MO 63044-2505 |
Taxonomy and Licenses
| Primary | Code | Classification | Specialization | Taxonomy Group | License Number | License State |
|---|---|---|---|---|---|---|
| N | 363LF0000X | Nurse Practitioner | Family | R 206334-6 | MN | |
| Y | 363L00000X | Nurse Practitioner | 2014024606 | MO |
Taxonomy Information
Primary Taxonomy
| Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| Classification | Nurse Practitioner |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses' Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
Other Taxonomy
| Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Definition: Definition to come...
Providers with the same taxonomy
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Kelene S Rousey | 1555 N Barrington Rd Ste 1200, Hoffman Estates, IL 60169-5036 | Nurse Practitioner | 2024-07-05 |
| Jean Donne | 1900 N University Dr, Pembroke Pines, FL 33024-3618 | Nurse Practitioner | 2024-07-06 |
| Nicole Martinez | 1721 E 19th Ave Ste 200, Denver, CO 80218-1242 | Nurse Practitioner | 2024-07-05 |
| Olivia Bayne | 1103 College Dr, Mena, AR 71953-2519 | Nurse Practitioner | 2024-07-05 |
| Keleac Ventures LLC | 4128 Maison Rdg, Dallas, TX 75219-3044 | Nurse Practitioner | 2024-07-06 |
| Michelle Lee Berg | 1 Veterans Dr, Minneapolis, MN 55417-2309 | Nurse Practitioner | 2024-07-06 |
| Nathalia Hernandez | 2494 Nw 186th Ave, Pembroke Pines, FL 33029-5306 | Nurse Practitioner | 2024-07-05 |
| Breann Kay Dalzell | 1746 W River Rd, Traverse City, MI 49696-8235 | Nurse Practitioner | 2024-07-05 |
| Elizabeth Marie Peche | 7979 Wurzbach Rd, San Antonio, TX 78229-4427 | Nurse Practitioner | 2024-07-06 |
| Erin Taylor Mcintyre | 2100 Pioneer Ave, Cheyenne, WY 82001-3608 | Nurse Practitioner | 2024-07-05 |
| Find all providers with the same taxonomy | |||
Location Information
| Street Address | 12345 SAINT CHARLES ROCK RD |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044-2505 |
| Country | US |
Providers in the same location
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Kelly Dejarnett | 12345 Saint Charles Rock Rd, Bridgeton, MO 63044-2505 | Pharmacist | 2011-09-28 |
| Melissa Bradbury | 12345 Saint Charles Rock Rd, Bridgeton, MO 63044-2505 | Pharmacist | 2020-08-13 |
| Nicole Radev | 12345 Saint Charles Rock Rd, Bridgeton, MO 63044-2505 | Pharmacist | 2022-10-19 |
| Carolyn Hager | 12345 Saint Charles Rock Rd, Bridgeton, MO 63044-2505 | Pharmacist | 2011-11-21 |
| Walgreen Co · Walgreens #02501 | 12345 Saint Charles Rock Rd, Bridgeton, MO 63044-2505 | Durable Medical Equipment & Medical Supplies | 2006-07-29 |
| Ronald Savetz | 12345 Saint Charles Rock Rd, Bridgeton, MO 63044-2505 | Pharmacist | 2011-09-28 |
| Wanna Janwatanagool | 12345 Saint Charles Rock Rd, Bridgeton, MO 63044-2505 | Pharmacist | 2011-09-30 |
| Walgreens Pharmacy | 12345 Saint Charles Rock Rd, Bridgeton, MO 63044-2505 | Department of Veterans Affairs (VA) Pharmacy | 2015-06-25 |
| Matthew Kahle | 12345 Saint Charles Rock Rd, Bridgeton, MO 63044-2505 | Pharmacist | 2015-03-20 |
| Angela B Johnson | 12345 Saint Charles Rock Rd, Bridgeton, MO 63044-2505 | Pharmacist | 2011-09-28 |
| Find all providers in the same location | |||
Providers in the same zip code
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Tiarra Denise Young | 12355 Depaul Drive, Bridgeton, MO 63044 | Community Health Worker | 2021-05-05 |
| Aida Junuzovic | 12266 Depaul Dr Suite 100, Bridgeton, MO 63044 | Student in an Organized Health Care Education/Training Program | 2022-01-07 |
| Lashonda Wendella Thomas | 12355 Depaul Drive Suite 150, Saint Louis, MO 63044 | Clinical Social Worker | 2023-11-27 |
| Tywana Burrow | 3430 Mc Kelvey Road Ste L Pmb 1388, Bridgeton, MO 63044 | Adult Day Care Clinic/Center | 2023-06-05 |
| Anna Leigh Martin | 12266 Depaul Drive, Suite 205, Bridgeton, MO 63044 | Acute Care Nurse Practitioner | 2023-02-28 |
| Brielle Holly Bright | 12380 Depaul Dr, Bridgeton, MO 63044 | Physical Therapist | 2021-07-27 |
| Delicate Angels Home Health LLC | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | Home Health Agency | 2019-08-16 |
| Rachel M Jones | 3430 Mc Kelvey Road Ste C, Bridgeton, MO 63044 | Adult Day Care Clinic/Center | 2023-10-03 |
| Nicholas Huber | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | Physical Therapist | 2019-08-12 |
| Zoe Marie Wadsworth · Zoe Marie Preis | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | Pediatric Nurse Practitioner | 2019-12-10 |
| Find all providers in the same zip code | |||
Similar Providers
Providers with similar names
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Abeba G. Hailu | 299 E Plumb Ln, Reno, NV 89502-3449 | Pharmacist | 2022-08-08 |
| Lidiya Hailu | 820 Upshur St Nw, Washington, DC 20011-5837 | Home Health Aide | 2016-08-16 |
| Saba Hailu | 5101 Wisconsin Ave Nw, Suite 250, Washington, DC 20016-4120 | Home Health Aide | 2012-06-13 |
| Hailu T Wakjera | 1511 Emancipation Hwy, Fredericksburg, VA 22401-4631 | Pharmacist | 2022-10-13 |
| Sara Hailu | 10701 Main St, Fairfax, VA 22030-6904 | Occupational Therapy Assistant | 2018-06-27 |
| Atalelech Hailu | 7826 Eastern Ave Nw Ste Ll16, Washington, DC 20012-1328 | Home Health Aide | 2012-07-17 |
| Bemnet Hailu | 1675 Dempster St, Park Ridge, IL 60068-1110 | Pediatrics Physician | 2016-03-24 |
| Yalemwork Hailu | 820 Upshur St Nw, Washington, DC 20011-5837 | Home Health Aide | 2012-07-07 |
| Theodoros Hailu | 5000 W Oakland Park Blvd, Lauderdale Lakes, FL 33313-1503 | Emergency Medicine Physician | 2006-02-17 |
| Afework M Hailu | 4940 Eastern Ave, Baltimore, MD 21224-2735 | Acute Care Nurse Practitioner | 2024-06-10 |
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Dataset Information
This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
| Subject | Transparency and Disclosure |
| Jurisdiction | Federal |
| Data Provider | National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS) |
| Source | download.cms.gov |
Dataset Details
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).
All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).
Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.
This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.
