NPIMap

Individual provider Active NPI

Casey Amanda Jennings, D. O.

  • Family Medicine Physician
  • Louisiana, MO
National Provider Identifier
1033300488
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2007018507 Issued in MO
Practice address
2305 Georgia St
Louisiana, MO 63353-2559
Phone
(573) 754-4584
Fax
(573) 754-5280
NPI assigned
Aug 8, 2007
Last updated
May 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2007018507 MO Primary

Addresses

Primary practice location

2305 Georgia St
Louisiana, MO 63353-2559

Mailing address

2305 Georgia St
Louisiana, MO 63353-2559
Phone (573) 754-4584

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cjennings@pike.cernerdirect.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
I20080721000302 MO Practitioner - Family Practice 2961575295 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pike County Memorial HospitalGroup PAC ID 8123015518, shared by 6 NPIs, 31 clinicians

Practice addresses (Care Compare)

1015 W Adams St
Bowling Green, MO 63334-1974
Phone (573) 324-5300

2305 Georgia St
Louisiana, MO 63353-2559

2305 W Georgia
Louisiana, MO 63353-2559

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2007018507MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pike County Memorial Hospital CurrentSince Mar 12, 2014 Accepting new patients
Pike County Memorial Hospital CurrentSince Jul 1, 2013 Accepting new patients
Pike County Memorial Hospital CurrentSince Jul 1, 2013 Accepting new patients
Pike County Memorial Hospital Family Medicine Current Accepting new patients
Pike County Memorial Hospital Past Accepting new patients

Locations

1015 W Adams St
Bowling Green, MO 63334
Phone (573) 324-5300

2305 Georgia St
Louisiana, MO 63353
Phone (573) 754-4584

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1033300488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 GEORGIA ST",
            "city": "LOUISIANA",
            "state": "MO",
            "postal_code": "633532559",
            "telephone_number": "573-754-4584",
            "fax_number": "573-754-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 GEORGIA ST",
            "city": "LOUISIANA",
            "state": "MO",
            "postal_code": "633532559",
            "telephone_number": "573-754-4584",
            "fax_number": "573-754-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "CASEY",
        "middle_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "D. O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2007018507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cjennings@pike.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Pike County Memorial Hospital Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2305 Georgia St",
            "city": "Louisiana",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633532559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisiana, MO

Sources for this page

Verify at the official NPI Registry.