Individual provider Active NPI

Jeane E Kiene, FNP-C

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1053787234
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2015027409 Issued in MO
Practice address
10012 Kennerly Rd
Suite 300
Saint Louis, MO 63128-2197
Phone
(314) 842-0602
Fax
(314) 842-4372
NPI assigned
Aug 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2015027409 MO Primary

Addresses

Primary practice location

10012 Kennerly Rd
Suite 300
Saint Louis, MO 63128-2197

Mailing address

10012 Kennerly Rd
Suite 300
Saint Louis, MO 63128-2197
Phone (314) 842-0602

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
I20150916002770 MO Practitioner - Nurse Practitioner 2769799105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Heart and Vascular LLCGroup PAC ID 8820016207, 112 clinicians

Practice addresses (Care Compare)

10012 Kennerly Rd
Suite 300
Saint Louis, MO 63128-2197
Phone (314) 842-0602

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Heart and Vascular, LLC CurrentSince Jan 1, 2020 Accepting new patients
Saint Luke'S Physician Group Inc Past Accepting new patients

Locations

1001 S Kirkwood Rd
Ste 310
Saint Louis, MO 63122
Phone (314) 692-2807

10012 Kennerly Rd
Ste 202
Saint Louis, MO 63128
Phone (314) 692-2807

4280 Mid America Ln
Ste 10
Saint Louis, MO 63129
Phone (314) 692-2807

625 S New Ballas Rd
Ste 2015
Saint Louis, MO 63141
Phone (314) 251-1775

7345 Watson Rd
#1
Saint Louis, MO 63119
Phone (314) 692-2807

10012 Kennerly Rd
Ste 300
Saint Louis, MO 63128
Phone (314) 842-0602

Organizations & group practices 2

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": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1053787234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD",
            "address_2": "SUITE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-842-0602",
            "fax_number": "314-842-4372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD",
            "address_2": "SUITE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-842-0602",
            "fax_number": "314-842-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIENE",
        "first_name": "JEANE",
        "middle_name": "E",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015027409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.