Individual provider Active NPI

Coleen R. Jones, WHNP-BC

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1053617407
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2011001943 Issued in MO
Practice address
4352 Manchester Ave
Saint Louis, MO 63110-2138
Phone
(314) 531-5444
Fax
(314) 531-0063
NPI assigned
Feb 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 2011001943 MO
Nurse Practitioner 363L00000X 2011001943 MO Primary

Addresses

Primary practice location

4352 Manchester Ave
Saint Louis, MO 63110-2138

Mailing address

6420 Clayton Rd Ste 290
Saint Louis, MO 63117-1811
Phone (314) 781-1505

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110412000113 MO Practitioner - Nurse Practitioner 5294919593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

1031 Bellevue Ave
Suite 400
Saint Louis, MO 63117-1858
Phone (314) 977-7455

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2011001943MOMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Health Centers CurrentSince Nov 18, 2025 Accepting new patients
SSM Health Care Group CurrentSince Dec 1, 2022 Accepting new patients
SSM Health Care Group CurrentSince Dec 1, 2022 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients

Locations

4352 Manchester Ave
Saint Louis, MO 63110
Phone (314) 371-0336

6420 Clayton Rd
Ste 290
Saint Louis, MO 63117
Phone (314) 781-1505

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

401 Holly Hills Ave
Saint Louis, MO 63111
Phone (314) 353-5190

1031 Bellevue Ave
Ste 400
Saint Louis, MO 63117

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1296604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1053617407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD STE 290",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-781-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4352 MANCHESTER AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102138",
            "telephone_number": "314-531-5444",
            "fax_number": "314-531-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "COLEEN",
        "middle_name": "R.",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-02",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MO",
            "license": "2011001943",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2011001943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.