Active NPI
Jessica Claire Lutker, APRN
- Adult Health Nurse Practitioner
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 2020034593
- Practice address
- 10012 Kennerly Rd Ste 400
Saint Louis, MO 63128-2197 - Phone
- (314) 543-5999
- Fax
- (314) 543-5994
- NPI assigned
- Oct 12, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 2020034593 | MO | Primary |
| Registered Nurse | 163W00000X | 2014039582 | MO |
Addresses
Primary practice location
10012 Kennerly Rd Ste 400
Saint Louis, MO 63128-2197
Mailing address
1223 N Rapp Ave
Columbia, IL 62236-1125
Phone (618) 340-1869
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10012 Kennerly Rd
Suite 400
Saint Louis, MO 63128-2197
Phone (314) 543-9999
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014039582 | MO | MD | Registered Nurse |
| 2020034593 | MO | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Surgical Specialists, LLC | Current | Accepting new patients | |
| Mercy Clinic East Communities | Past | Accepting new patients |
Locations
10012 Kennerly Rd
Ste 400
Saint Louis, MO 63128
Phone (314) 525-1258
621 S New Ballas Rd
Ste 3005B
Saint Louis, MO 63141
Phone (314) 251-7070
851 E 5th St
Ste 108
Washington, MO 63090
Phone (636) 239-4144
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.
-
- Vascular Surgery Physician
- Washington, MO
- NPI 1043530538
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1851335228
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1568481984
-
dba Mercy Hospital St Louis
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1427098169
-
dba Mercy St. Louis Transport Ambulance
- Land Ambulance
- Saint Louis, MO
- NPI 1881329902
Hospital
-
- Rehabilitation Hospital
- Richmond Heights, MO
- NPI 1659511988
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1053919118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1223 N RAPP AVE",
"city": "COLUMBIA",
"state": "IL",
"postal_code": "622361125",
"telephone_number": "618-340-1869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10012 KENNERLY RD STE 400",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631282197",
"telephone_number": "314-543-5999",
"fax_number": "314-543-5994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTKER",
"first_name": "JESSICA",
"middle_name": "CLAIRE",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-12",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MO",
"license": "2020034593",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2014039582",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
- Lutheran Senior Services (LSS Palliative Care)
- Lutheran Senior Services (LSS Hospice Care)
- Lutheran Senior Services (Lutheran Senior Services Home Health)
- Nimisha Luthra, L.P.C. (PROVISIONAL)
- Scott M Luthy, RPH
- Natalie Lutkewitte
- Abigail Lutomski
- Kimberly Susan Lutz, BCABA
- Lauren Michelle Lutz, FNP
- Mary E Lutz, MSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.