Jessica Therese Auld, MD
Individual provider Active NPI Family Medicine Physician · Fenton, MO
NPI 1366071672 · NPPES record last updated Jul 24, 2023
Key facts
- NPI
- 1366071672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2022047390 (MO)
- Practice address
- 1203 Smizer Mill Rd Ste 105
Fenton, MO 63026-3483 - Phone
- (636) 717-1350
- NPI assigned
- Apr 7, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Medical College of Wisconsin, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Clinic East Communities
Practice addresses (Care Compare)
1203 Smizer Mill Rd
Suite 105
Fenton, MO 63026-3483
Phone (636) 717-1350
Hospital & facility affiliations
- Mercy Hospital St Louis
- Mercy Hospital South
- Mercy Hospital Washington
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230814001767 | MO | Practitioner - Family Practice | 3971928342 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic East Communities | Family Medicine | Current |
Accepting new patients |
Locations
1203 Smizer Mill Rd
Ste 105
Fenton, MO 63026
Phone (636) 717-1350
621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335
621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2022047390 | MO | Yes |
Addresses
Primary practice location
1203 Smizer Mill Rd Ste 105
Fenton, MO 63026-3483
Mailing address
PO Box 776084
Chicago, IL 60677-6084
Phone (636) 717-1350
Other providers in Fenton, MO
- Staci Archibald
- Aspire Wellness STL, LLC
- Megan Assareh
- Athletico LTD
- Kristin Blair Aubuchon
- Anastasia A Averbukh
- Natalie Faye Babb
- Cynthia Ann Babcock
- Christina R Baeres
- Emily Bahram-Ahi
All providers in Fenton, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.