Jeannette Marie Bender, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Fenton, MO
NPI 1104478494 · NPPES record last updated Oct 20, 2020
Key facts
- NPI
- 1104478494
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2018040085 (MO)
- Practice address
- 1011 Bowles Ave Ste 425
Fenton, MO 63026-2384 - Phone
- (636) 496-5030
- NPI assigned
- Jul 16, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- SSM Medical Group Inc
Practice addresses (Care Compare)
1011 Bowles Ave
Suite 425
Fenton, MO 63026-2384
Phone (636) 496-5030
Hospital & facility affiliations
- SSM St Clare Health Center
- SSM Health St Mary'S Hospital - St Louis
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190731000379 | MO | Practitioner - Nurse Practitioner | 8628304524 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018040085 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Medical Group, Inc. | Current |
Accepting new patients | |
| SSM Medical Group Inc. | Current |
Accepting new patients | |
| SSM Health Care St. Louis | Past | Accepting new patients |
Locations
3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044
1011 Bowles Ave
Ste 205
Fenton, MO 63026
Phone (314) 966-8118
1011 Bowles Ave
Ste 425
Fenton, MO 63026
Phone (636) 326-2600
1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115
3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100
Interoperability endpoints
- jbender161401@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2018040085 | MO | Yes |
Addresses
Primary practice location
1011 Bowles Ave Ste 425
Fenton, MO 63026-2384
Mailing address
PO Box 955534
Saint Louis, MO 63195-3329
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | jeannette_bender@ssmhc.com | Direct | |
| Direct Messaging Address | jbender161401@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Other providers in Fenton, MO
- Laura Louise Bechtold
- Stephanie Jean Becker-Koepke
- Lauren Melissa Beckmann
- Alexandra Behrens
- Bemes Home Medical Inc
- Achintya Narendra Benegal
- Bennett Rehab Services, LLC
- Erika May Benson
- Bent Back Chiropractic, LLC
- Caitlin Berkbigler
All providers in Fenton, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.