Jaclyn Morris, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2022014490 Issued in MO

Practice address

300 Medical PLZ Ste 310
Lake Saint Louis, MO 63367-1484

Phone

(636) 625-2662

NPI assigned

Apr 22, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jmorris354153@direct-ehr-ssmhc.com

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.

• SSM Health Care St. Louis

  dba SSM Health St. Joseph Hospital - St. Charles Physician Billing

  • Emergency Medicine Physician
  • Saint Charles, MO
  • NPI 1427002922
  NPD (past)

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1053055368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3747 FRENCH AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631164044",
            "telephone_number": "816-721-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLZ STE 310",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633671484",
            "telephone_number": "636-625-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "JACLYN",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-22",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2022014490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercy Pharmacy Services LLC (Mercy Pharmacy Lake St. Louis)
• Christopher James Miller, MD
• Missouri Dental Professionals, Richard Straus, D.M.D., P.C. (Lake St. Louis Dental Care)
• Missouri Dental Professionals, Richard Straus, DMD, PC (Brevco Family Dentistry)
• Vidal Luis Mora, L.A.T., A.T.C.
• Danielle E Nash, DC
• Nicole Barker, LPC, LLC
• Veronica Njwaba, DNP, FNP- BC
• NP Johnson Telehealth Wellness Care, LLC
• Judith Ann Payne, LPC

• Pediatric Nurse Practitioner in Lake Saint Louis, MO
• Providers in Lake Saint Louis, MO by specialty
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.