Individual provider Active NPI

Jessica N Stricklin, PA-C

  • Physician Assistant
  • Godfrey, IL
National Provider Identifier
1124650353
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085007532 Issued in IL
Practice address
5213 Godfrey Rd Ste 110
Godfrey, IL 62035-2510
Phone
(618) 619-3330
Fax
(618) 619-3390
NPI assigned
Feb 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085007532 IL Primary

Addresses

Primary practice location

5213 Godfrey Rd Ste 110
Godfrey, IL 62035-2510

Mailing address

PO Box 959203
Saint Louis, MO 63195-9203
Phone (618) 619-3330

Other practice location 1

4500 Memorial Dr
Belleville, IL 62226-5399
Phone (618) 223-7750

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL FHIR PROTESTANT MEMORIAL MEDICAL CENTER,INC.

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20200417000109 IL Practitioner - Physician Assistant 7012347958 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

163 E Bethalto Dr
Bethalto, IL 62010-1801
Phone (618) 433-6640

5213 Godfrey Rd
Suite 110
Godfrey, IL 62035-2510
Phone (618) 619-3330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085007532ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Feb 1, 2022 Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

2122 Troy Rd
Ste 130
Edwardsville, IL 62025
Phone (618) 692-9876

5213 Godfrey Rd
Ste 110
Godfrey, IL 62035
Phone (618) 619-3330

5520 Godfrey Rd
Ste B
Godfrey, IL 62035
Phone (618) 463-7800

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

660 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 463-6950

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18118/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1124650353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959203",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631959203",
            "telephone_number": "618-619-3330",
            "fax_number": "618-619-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5213 GODFREY RD STE 110",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620352510",
            "telephone_number": "618-619-3330",
            "fax_number": "618-619-3390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622265399",
            "country_code": "US",
            "telephone_number": "618-223-7750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STRICKLIN",
        "first_name": "JESSICA",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5213 Godfrey Rd Ste 110",
            "city": "Godfrey",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620352510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "FHIR",
            "affiliation": "Y",
            "affiliationName": "PROTESTANT MEMORIAL MEDICAL CENTER,INC.",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Applicable Programming Interfare (API)",
            "address_1": "4500 Memorial Dr",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622265360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Godfrey, IL

Sources for this page

Verify at the official NPI Registry.