Jacqueline Elise Kirk, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2021099690 Issued in MO

Practice address

10004 Kennerly Rd Ste 362B
Saint Louis, MO 63128-2178

Phone

(314) 525-5050

Fax

(314) 525-5072

NPI assigned

Sep 23, 2021

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

Other names 1

• Jacqueline E Dodd Former name

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community and Long-Term Care Psychiatry LLCGroup PAC ID 4486949773, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081
• Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

Merit-based Incentive Payment System (MIPS)

Final score

95.86 of 100Reported as group

Quality

70.88

Promoting interoperability

100

Improvement activities

40

Cost

82.7

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jacqueline.kirk.1@20454.direct.athenahealth.com

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.

• Community and Long-Term Care Psychiatry LLC

  • Psychiatry Physician
  • Saint Louis, MO
  • NPI 1699121475
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Fenton, MO
  • NPI 1851496152
  Care Compare affiliation

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1326719964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD STE 362B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282178",
            "telephone_number": "314-525-5050",
            "fax_number": "314-525-5072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD STE 362B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282178",
            "telephone_number": "314-525-5050",
            "fax_number": "314-525-5072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "JACQUELINE",
        "middle_name": "ELISE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2021099690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "DODD",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carrie Kirchner
• Faith Kirchner
• Scott A Kirchner, MD
• Karen Kirchoff Dysart, MA, LPC
• Kirk Barron Chiropractic, LLC
• Levi S Kirkland Jr., M.D.
• Erin Ashley Kirkpatrick, LPC, ATR
• Holly Elizabeth Kirkpatrick, CRNA
• Orisia S Kirkpatrick, CRNA
• Summer Ann Kirkpatrick, MD

• Psychiatric/Mental Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.