NPIMap

Individual provider Active NPI

Jennifer J Patterson, M.D.

  • Family Medicine Physician
  • Independence, MO
National Provider Identifier
1083873558
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2008008631 Issued in MO
Practice address
4721 S Cliff Ave
Suite 200
Independence, MO 64055-7016
Phone
(816) 503-3700
Fax
(816) 503-3704
NPI assigned
Jun 9, 2008
Last updated
Jan 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2008008631 MO Primary

Addresses

Primary practice location

4721 S Cliff Ave
Suite 200
Independence, MO 64055-7016

Mailing address

4721 S Cliff Ave
Suite 200
Independence, MO 64055-7016
Phone (816) 503-3700

Other identifiers 2

IdentifierTypeStateIssuer
1083873558MedicaidMO
200574010AMedicaidKS

Other names 1

  • Jennifer J Marcellus Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JENNIFER.PATTERSON@hca2.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081010000295 MO Practitioner - Family Practice 0042388514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Columbia School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care of E. Jackson County LLCGroup PAC ID 8426068693, 10 clinicians

Practice addresses (Care Compare)

19600 E 39TH St S
Independence, MO 64057-2301
Phone (816) 698-7000

4911 S Arrowhead Dr
Independence, MO 64055-7008
Phone (816) 503-3700

725 N 7 Hwy
Blue Springs, MO 64014-2426
Phone (816) 229-8187

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care of E. Jackson County LLC Family Medicine CurrentSince Mar 30, 2015 Accepting new patients
Midwest Heart & Vascular Specialists, LLC Past Accepting new patients

Locations

725 NW State Route 7
Ste B
Blue Springs, MO 64014
Phone (816) 229-8187

4721 S Cliff Ave
Ste 200
Independence, MO 64055
Phone (816) 503-3700

4911 S Arrowhead Dr
Ste 200
Independence, MO 64055
Phone (816) 503-3700

Interoperability endpoints

  • Direct secure messaging: jennifer.patterson@hca2.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1083873558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4721 S CLIFF AVE",
            "address_2": "SUITE 200",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640557016",
            "telephone_number": "816-503-3700",
            "fax_number": "816-503-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4721 S CLIFF AVE",
            "address_2": "SUITE 200",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640557016",
            "telephone_number": "816-503-3700",
            "fax_number": "816-503-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2008008631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083873558",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200574010A",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JENNIFER.PATTERSON@hca2.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "4721 S Cliff Ave",
            "address_2": "SUITE 200",
            "city": "Independence",
            "state": "MO",
            "country_code": "US",
            "postal_code": "640557016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MARCELLUS",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.