Individual provider Active NPI

Jacqueline Hellwege Rickard, M.D.

  • Family Medicine Physician
  • Chesterfield, MO
National Provider Identifier
1336235928
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2013010801 Issued in MO
Practice address
15740 S Outer 40 Rd
Chesterfield, MO 63017
Phone
(636) 735-4268
NPI assigned
Oct 4, 2006
Last updated
May 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2006001808 MO
Family Medicine Physician 207Q00000X 036-117466 IL
Family Medicine Physician 207Q00000X 2013010801 MO Primary
Hospitalist Physician 208M00000X 036-117466 IL

Addresses

Primary practice location

15740 S Outer 40 Rd
Chesterfield, MO 63017

Mailing address

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone (636) 735-4268

Other practice location 1

211 S 3rd St
Belleville, IL 62220-1915
Phone (618) 234-2120

Other identifiers 1

IdentifierTypeStateIssuer
036117466MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130815000886 MO Practitioner - Family Practice 0244330629 Reassigns benefits to 5 organizations
I20210309002351 AR Practitioner - Family Practice 0244330629 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006001808MOMDFamily Medicine Physician
036-117466ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Dec 24, 2018 Accepting new patients
Mercy Aco Clinical Services Inc Hospitalist CurrentSince Mar 9, 2020 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Dec 24, 2018 Accepting new patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Dr. Petre I Anguelinin, LLC CurrentSince Jul 1, 2013 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jan 1, 2021 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jan 1, 2021 Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince Sep 14, 2019 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Dec 24, 2018 Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

2708 S Rife Medical Ln
Ste T30
Rogers, AR 72758
Phone (479) 338-3999

15740 South Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 735-4268

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 110
Rolla, MO 65401
Phone (573) 458-6300

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

621 S New Ballas Rd
Ste 399A
Saint Louis, MO 63141
Phone (314) 251-1820

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1336235928",
    "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": "211 S 3rd St",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622201915",
            "country_code": "US",
            "telephone_number": "618-234-2120",
            "fax_number": "618-641-5806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICKARD",
        "first_name": "JACQUELINE",
        "middle_name": "HELLWEGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2006001808",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-117466",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2013010801",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036-117466",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036117466",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.