Jessica Lynn Boedeker, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2018032910 Issued in MO

Practice address

621 S New Ballas Rd Ste 5003B
Saint Louis, MO 63141-8270

Phone

(314) 251-8892

NPI assigned

Jun 20, 2019

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

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Hospital LincolnGroup PAC ID 5193040020, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Lincoln Hospital, Troy, MO, CCN 261319
• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jboedeker1030717@directc.mercy.net

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.

• Mercy Hospital Lincoln

  • Critical Access Hospital
  • Troy, MO
  • NPI 1962808733
  Medicare reassignment Care Compare group NPD
• Mercy Hospital Lincoln

  • Rural Health Clinic/Center
  • Elsberry, MO
  • NPI 1578969366
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Lincoln

  • Critical Access Hospital
  • Troy, MO
  • NPI 1962808733
  Care Compare affiliation
• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1093375115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 LILLEY LN",
            "city": "ELSBERRY",
            "state": "MO",
            "postal_code": "633433167",
            "telephone_number": "636-236-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 5003B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418270",
            "telephone_number": "314-251-8892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEDEKER",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018032910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Body Mind Healing Center LLC
• Hannah Elizabeth Boe, MD
• Emily Therese Boeckenstedt
• Philip Boeckmann, PT
• James Boedeker, M.D.
• Michael Boeger
• Claire Rose Boehm
• Paul Herbert Boehme, D.D.S.
• William Boehning III
• Martha K Boelter, D.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; 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.

Verify at the official NPI Registry.