Individual provider Active NPI

Jennifer Krause, M.D.

  • Pediatrics Physician
  • Jefferson City, MO
National Provider Identifier
1255361036
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2003010048 Issued in MO
Practice address
3348 American Ave
Jefferson City, MO 65109-1079
Phone
(573) 761-7210
Fax
(573) 634-8802
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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 2003010048 MO Primary

Addresses

Primary practice location

3348 American Ave
Jefferson City, MO 65109-1079

Mailing address

3348 American Ave
Jefferson City, MO 65109-1079
Phone (573) 761-7210

Other identifiers 1

IdentifierTypeStateIssuer
208748400MedicaidMO

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jkrause12177@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040805000539 MO Practitioner - Pediatric Medicine 5799756334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as group
Quality
86.39
Promoting interoperability
100
Improvement activities
40
Cost
73.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2003010048MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Regional Health Services CurrentSince Jan 1, 2013 Accepting new patients
SSM Regional Health Services CurrentSince Jan 1, 2013 Accepting new patients
SSM Regional Health Services Past Accepting new patients
SSM Regional Health Services Past Accepting new patients

Locations

7655 Solutions Ctr
Chicago, IL 60677

3348 American Ave
Jefferson City, MO 65109
Phone (573) 761-7210

100 Saint Marys Plz
Jefferson Cty, MO 65101
Phone (573) 635-7642

200 Saint Marys Plz
Ste 301
Jefferson Cty, MO 65101
Phone (573) 634-4212

Interoperability endpoints

  • Direct secure messaging: jkrause12177@direct-ehr-ssmhc.com

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1255361036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3348 AMERICAN AVE",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651091079",
            "telephone_number": "573-761-7210",
            "fax_number": "573-634-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3348 AMERICAN AVE",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651091079",
            "telephone_number": "573-761-7210",
            "fax_number": "573-634-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSE",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2003010048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208748400",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkrause12177@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jkrause12177@direct-ehr-ssmhc.com",
            "address_1": "3348 American Ave",
            "city": "Jefferson City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "651091079",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3348 American Ave",
            "city": "Jefferson City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "651091079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.