Individual provider Active NPI

Jennifer Sticken, PA

  • Physician Assistant
  • Raymore, MO
National Provider Identifier
1356685556
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2017010108 Issued in MO
Practice address
1010 Remington PLZ
Raymore, MO 64083
Phone
(888) 403-1071
NPI assigned
Nov 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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 2017010108 MO Primary

Addresses

Primary practice location

1010 Remington PLZ
Raymore, MO 64083

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131

Other practice location 1

1600 N Lorraine St
202
Hutchinson, KS 67501-5670
Phone (620) 663-7595

Other practice location 2

1032 Crosswinds Ct
Wentzville, MO 63385-4836
Phone (844) 853-8937

Other practice location 3

227 Metro Dr
Jefferson City, MO 65109-1134
Phone (844) 853-8937

Other practice location 4

1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-8899

Other practice location 5

1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 364-9000

Other practice location 6

1450 E 10th St
Rolla, MO 65401-3648
Phone (844) 853-8937

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170405001569 MO Practitioner - Physician Assistant 8527213826 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017010108MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc CurrentSince Mar 6, 2017 Accepting new patients
Compass Health, Inc CurrentSince Mar 6, 2017 Accepting new patients

Locations

1800 Community
#B
Clinton, MO 64735

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

227 Metro Dr
Jefferson Cty, MO 65109
Phone (573) 634-3000

501 N Sunset Ln
Raymore, MO 64083
Phone (448) 538-9378

1010 Remington Plz
Raymore, MO 64083
Phone (816) 318-4430

1450 E 10th St
Rolla, MO 65401
Phone (573) 364-7551

1032 Crosswinds Ct
Wentzville, MO 63385
Phone (636) 332-6000

Organizations & group practices 2

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": "1352678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1356685556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 REMINGTON PLZ",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "64083",
            "telephone_number": "888-403-1071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 N Lorraine St",
            "address_2": "202",
            "address_purpose": "LOCATION",
            "city": "Hutchinson",
            "state": "KS",
            "postal_code": "675015670",
            "country_code": "US",
            "telephone_number": "620-663-7595",
            "fax_number": "620-663-5263",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1032 Crosswinds Ct",
            "address_purpose": "LOCATION",
            "city": "Wentzville",
            "state": "MO",
            "postal_code": "633854836",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "227 Metro Dr",
            "address_purpose": "LOCATION",
            "city": "Jefferson City",
            "state": "MO",
            "postal_code": "651091134",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654012905",
            "country_code": "US",
            "telephone_number": "573-458-8899",
            "fax_number": "573-341-5611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654012905",
            "country_code": "US",
            "telephone_number": "573-364-9000",
            "fax_number": "573-202-2484",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1450 E 10th St",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654013648",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STICKEN",
        "first_name": "JENNIFER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-12",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2017010108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raymore, MO

Sources for this page

Verify at the official NPI Registry.