Individual provider Active NPI

Jenny L Wiemann, D.C.

  • Chiropractor
  • St Peters, MO
National Provider Identifier
1093741407
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CE006000 Issued in MO
Practice address
331A Jungermann Rd
St Peters, MO 63376-5351
Phone
(636) 928-5588
Fax
(636) 922-0071
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CE006000 MO Primary

Addresses

Primary practice location

331A Jungermann Rd
St Peters, MO 63376-5351

Mailing address

331A Jungermann Rd
St Peters, MO 63376-5351
Phone (636) 928-5588

Other identifiers 8

IdentifierTypeStateIssuer
4319076OtherMOAETNA
P00115373OtherMORAILROAD MEDICARE
3560OtherMOBLUE CROSS BLUE SHIELD
431738059CROOtherMOMERCY
612612OtherMOACN
178092OtherMOHEALTHLINK
52473OtherMOGHP
4407107OtherMOUHC

Other names 1

  • Jenny L Crosby Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111121000068 MO Practitioner - Chiropractic 3678619863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1991
Medicare assignment
May accept Medicare assignment
Group practices
Jenny L Wiemann DC PCGroup PAC ID 3577506971, 4 clinicians

Practice addresses (Care Compare)

331 Jungermann Rd
Suite a
Saint Peters, MO 63376-5351
Phone (636) 928-5588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CE006000MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Jenny L Wiemann DCPC Chiropractor CurrentSince Oct 1, 2001 Accepting new patients

Locations

331 Jungermann Rd
Saint Peters, MO 63376
Phone (636) 928-5588

331 Jungermann Rd
Ste A
Saint Peters, MO 63376
Phone (636) 928-5588

331 Jungermann Rd
#A
Saint Peters, MO 63376
Phone (636) 928-5588

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1093741407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331A JUNGERMANN RD",
            "city": "ST PETERS",
            "state": "MO",
            "postal_code": "633765351",
            "telephone_number": "636-928-5588",
            "fax_number": "636-922-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331A JUNGERMANN RD",
            "city": "ST PETERS",
            "state": "MO",
            "postal_code": "633765351",
            "telephone_number": "636-928-5588",
            "fax_number": "636-922-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEMANN",
        "first_name": "JENNY",
        "middle_name": "L",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "CE006000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4319076",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00115373",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3560",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "431738059CRO",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "612612",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "178092",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "52473",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "4407107",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "CROSBY",
            "middle_name": "L",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in St Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.