Individual provider Active NPI

Jeanine Michelle Weinkauf, AGNP

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1235624479
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2018009356 Issued in MO
Practice address
12977 N 40 Dr Ste 309
Saint Louis, MO 63141-8654
Phone
(314) 301-9107
Fax
(314) 207-0261
NPI assigned
Jun 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 2018009356 MO
Adult Health Nurse Practitioner 363LA2200X 2018009356 MO Primary

Addresses

Primary practice location

12977 N 40 Dr Ste 309
Saint Louis, MO 63141-8654

Mailing address

5323 Robert Ave
Saint Louis, MO 63109-4063
Phone (314) 258-5220

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181017000676 MO Practitioner - Nurse Practitioner 2668724857 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Medwin Primary Care L.L.C. CurrentSince Sep 5, 2018 Accepting new patients

Locations

3619 Richardson Square Dr
Ste 150
Arnold, MO 63010
Phone (636) 461-1414

3619 Richardson Square Dr
Arnold, MO 63010
Phone (636) 461-1414

1688 Gravois Rd
High Ridge, MO 63049
Phone (636) 677-5776

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": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1235624479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 ROBERT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631094063",
            "telephone_number": "314-258-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12977 N 40 DR STE 309",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418654",
            "telephone_number": "314-301-9107",
            "fax_number": "314-207-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINKAUF",
        "first_name": "JEANINE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-29",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2018009356",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2018009356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.