Jodie Tankersley, AGPCNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2016025283 Issued in MO

Practice address

15740 S Outer 40 Rd
Chesterfield, MO 63017

Phone

(636) 735-4268

NPI assigned

Sep 7, 2016

Last updated

Sep 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2025 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1306393350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15740 S OUTER 40 RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172004",
            "telephone_number": "636-735-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15740 S OUTER 40 RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "636-735-4268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15740 S Outer 40 Rd",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "63017",
            "country_code": "US",
            "telephone_number": "636-735-4268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANKERSLEY",
        "first_name": "JODIE",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2016025283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tahir Medical Services, LLC
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• Desalena Tallman, DC
• Manirul Tamal, MD
• Michelle Jiahui Tang, MD, PHD
• Tariq Sarfraz Khan Tanoli, M.D.
• Lisa Tarica, CST
• Choudary V Tarigopula, MD
• Ellis R Taylor Jr., MD
• Jeff Taylor, MA LPC

• Adult Health Nurse Practitioner in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.