Individual provider Active NPI

Jamie Lee Reynolds, PA

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1285884593
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2014035190 Issued in MO
Practice address
11133 Dunn Rd
Div Im Medical Oncology
Saint Louis, MO 63136-6163
Phone
(800) 647-2098
Fax
(314) 362-3192
NPI assigned
Sep 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 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 2014035190 MO Primary

Addresses

Primary practice location

11133 Dunn Rd
Div Im Medical Oncology
Saint Louis, MO 63136-6163

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (800) 647-2098

Other identifiers 1

IdentifierTypeStateIssuer
220042815MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160805000653 MO Practitioner - Physician Assistant 4880744671 Reassigns benefits to 2 organizations
I20250113002372 IL Practitioner - Physician Assistant 4880744671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone (314) 747-3000

10 Barnes W Dr
Saint Louis, MO 63141-6350

150 Entrance Way
St Peters Siteman Cancer Center
St Peters, MO 63376-1645
Phone (636) 916-9920

4500 Forest Park Ave
Saint Louis, MO 63108-2114

5201 Mid America PLZ
Saint Louis, MO 63129-0002

5225 Mid America PLZ
Saint Louis, MO 63129-0002
Phone (800) 647-2098

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014035190MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Mar 1, 2020 Accepting new patients
Washington University CurrentSince Mar 1, 2020 Accepting new patients
Washington University Physicians in Illinois Inc CurrentSince Nov 9, 2024 Accepting new patients
Washington University Physicians in Illinois, Inc CurrentSince Nov 9, 2024 Accepting new patients
Washington University Past Accepting new patients
Washington University Physicians in Illinois, Inc Past Accepting new patients
Hematology Oncology Associates Inc Past Accepting new patients

Locations

1404 Cross St
Shiloh, IL 62269
Phone (618) 607-1000

1418 Cross St
Ste 180
Shiloh, IL 62269
Phone (618) 607-1340

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

5225 Mid America Plz
Ste D115
Saint Louis, MO 63129
Phone (314) 286-2500

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

660 S Euclid Ave
#8015
Saint Louis, MO 63110
Phone (314) 286-1018

660 S Euclid Ave
Saint Louis, MO 63110

660 S Euclid Ave
#8056
Saint Louis, MO 63110
Phone (314) 747-4901

8 Millstone Campus Dr
Saint Louis, MO 63146
Phone (314) 273-4375

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

Organizations & group practices 8

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": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1285884593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "800-647-2098",
            "fax_number": "314-362-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD",
            "address_2": "DIV IM MEDICAL ONCOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366163",
            "telephone_number": "800-647-2098",
            "fax_number": "314-362-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JAMIE",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2014035190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220042815",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "11133 Dunn Rd",
            "address_2": "Div IM Medical Oncology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631366163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.