Individual provider Active NPI

Jenny Le, DO

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1184364945
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2025039491 Issued in MO
Practice address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone
(314) 268-4070
Fax
(314) 268-4019
NPI assigned
Mar 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2025039491 MO Primary

Addresses

Primary practice location

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Mailing address

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 268-4070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251211003702 MO Practitioner - Pediatric Medicine 7517348477 Reassigns benefits to 1 organization
I20251216002865 IL Practitioner - Pediatric Medicine 7517348477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1402 S Grand Blvd
RM M260
Saint Louis, MO 63104-1004

7344 Solutions Ctr
Chicago, IL 60677-7003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025039491MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St Louis CurrentSince Oct 6, 2025 Accepting new patients
SSM Cardinal Glennon Childrens Hospital Pediatrics CurrentSince Oct 9, 2025 Accepting new patients
SSM Cardinal Glennon Children's Hospital Pediatrics CurrentSince Oct 9, 2025 Accepting new patients
SSM Health Care St. Louis CurrentSince Oct 6, 2025 Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

3403 Anderson Healthcare Dr
#B
Edwardsville, IL 62025
Phone (618) 288-5606

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

Interoperability endpoints

  • Direct secure messaging: jle210122@direct-ehr-ssmhc.com

Organizations & group practices 5

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": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1184364945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-268-4070",
            "fax_number": "314-268-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-268-4070",
            "fax_number": "314-268-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "JENNY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2025039491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.