Individual provider Active NPI

Jedsia Omega Brown

  • Psychiatric/Mental Health Nurse Practitioner
  • Swansea, IL
National Provider Identifier
1033094545
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2025032879 Issued in MO
Practice address
209 W Pointe Dr Ste D
Swansea, IL 62226-8310
Phone
(618) 641-3588
NPI assigned
Aug 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2025032879 MO Primary

Addresses

Primary practice location

209 W Pointe Dr Ste D
Swansea, IL 62226-8310

Mailing address

320 Sturbridge Village Dr
Hazelwood, MO 63042-2129
Phone (314) 683-0094

Other practice location 1

10922 Schuetz Rd
Saint Louis, MO 63146-5704
Phone (314) 440-8703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20251007001278 IL Practitioner - Nurse Practitioner 3072010107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimum Mental Health HealingGroup PAC ID 5698144608, 4 clinicians

Practice addresses (Care Compare)

209 W Pointe Dr
Suite D
Swansea, IL 62226-8310
Phone (618) 641-3588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025032879MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Mental Health Healing Psychiatric/Mental Health CurrentSince Aug 1, 2025 Accepting new patients

Locations

209 W Pointe Dr
Ste D
Swansea, IL 62226
Phone (618) 222-6778

10922 Schuetz Rd
Saint Louis, MO 63146
Phone (314) 612-4827

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1754438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1033094545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 STURBRIDGE VILLAGE DR",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630422129",
            "telephone_number": "314-683-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W POINTE DR STE D",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622268310",
            "telephone_number": "618-641-3588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10922 Schuetz Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631465704",
            "country_code": "US",
            "telephone_number": "314-440-8703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JEDSIA",
        "middle_name": "OMEGA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-06",
        "last_updated": "2025-08-06",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2025032879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swansea, IL

Sources for this page

Verify at the official NPI Registry.