Individual provider Active NPI

Jennifer Brooke Halligan, DPM

  • Podiatrist
  • Gladstone, MO
National Provider Identifier
1033353115
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
2007029461 Issued in MO
Practice address
2800 NE 60TH St
Gladstone, MO 64119-2036
Phone
(816) 453-5161
Fax
(816) 453-5874
NPI assigned
Apr 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 2007029461 MO Primary

Addresses

Primary practice location

2800 NE 60TH St
Gladstone, MO 64119-2036

Mailing address

2800 NE 60TH St
Gladstone, MO 64119
Phone (816) 453-5161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090709000314 MO Practitioner - Podiatry 4284786047 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preferred Podiatry Group PCGroup PAC ID 3971412677, 131 clinicians

Practice addresses (Care Compare)

1000 Wyndham Park Dr
Saint Peters, MO 63376-2989
Phone (636) 279-1260

Merit-based Incentive Payment System (MIPS)

Final score
92.69 of 100Reported as group
Quality
88.35
Promoting interoperability
97
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as group
Quality
72.99
Improvement activities
40
Cost
75.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue2321
Removal or shaving of skin growth819

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2007029461MOMDPodiatrist

Practice roles (6 of 9)

OrganizationSpecialtyStatusNew patients
Saint Lukes Hospital of Chillicothe CurrentSince Jan 1, 2013 Accepting new patients
Preferred Podiatry Group PC Podiatrist CurrentSince Mar 19, 2024 Accepting new patients
Preferred Podiatry Group PC Podiatrist CurrentSince Mar 19, 2024 Accepting new patients
Saint Lukes Hospital of Chillicothe CurrentSince Jan 1, 2013 Accepting new patients
Mid America Foot and Ankle Specialist, PC PastSince Jul 1, 2009 Accepting new patients
Comprehensive Foot Centers P.a. Past Accepting new patients

Locations

2600 Miller St
Bethany, MO 64424
Phone (660) 425-2211

1502 N Jefferson St
Carrollton, MO 64633
Phone (660) 542-1695

2799 N Washington St
Chillicothe, MO 64601
Phone (660) 214-8300

1550 Villa Dr
De Soto, MO 63020
Phone (636) 586-6559

3002 John Duffy Dr
Joplin, MO 64804
Phone (417) 553-9767

3000 NE 64th St
Kansas City, MO 64119
Phone (816) 393-6762

1000 Wyndham Park Dr
Saint Peters, MO 63376
Phone (636) 279-1260

Networks

  • IA HMO C-SNP
  • IA HMO
  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d

Organizations & group practices 6

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": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1033353115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 NE 60TH ST",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "64119",
            "telephone_number": "816-453-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 NE 60TH ST",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641192036",
            "telephone_number": "816-453-5161",
            "fax_number": "816-453-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIGAN",
        "first_name": "JENNIFER",
        "middle_name": "BROOKE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MO",
            "license": "2007029461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, MO

Sources for this page

Verify at the official NPI Registry.