Jessica Whelan LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

JESSICA WHELAN LLC

Practice address

301 S Main St
Dupo, IL 62239-1325

Phone

(314) 470-1220

Fax

(833) 914-0432

NPI assigned

May 19, 2020

Organization subpart

Yes

Parent organization

HOLON INCLUSIVE HEALTH SYSTEMAs reported in NPPES

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

Authorized official

Name

Dr. Jessica Ann Whelan, BA,FPMHNP-BC, RN-BC

Title

Ceo

Phone

(314) 470-1220

Specialties & licenses 15

Addresses

Other identifiers 4

Other names 1

• Holon Inclusive Health System Doing business as

Electronic endpoints 2

Part of

Jessica Whelan LLC

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica Giddens, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Caseyville, IL
  • NPI 1033544747
  NPD
• Lori Anne Hopwood, FNP-BC, WHNP

  • Family Nurse Practitioner
  • Litchfield, IL
  • NPI 1588976930
  NPD (past)
• Karen Antoinette Mayers-Scott, FNP-BC

  • Family Nurse Practitioner
  • Austin, TX
  • NPI 1033596382
  NPD (past)

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1417570920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16549 CLAYTON RD",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630111720",
            "telephone_number": "636-236-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S MAIN ST",
            "city": "DUPO",
            "state": "IL",
            "postal_code": "622391325",
            "telephone_number": "314-470-1220",
            "fax_number": "833-914-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA WHELAN LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOLON INCLUSIVE HEALTH SYSTEM",
        "enumeration_date": "2020-05-19",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "WHELAN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-470-1220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BA,FPMHNP-BC, RN-BC"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUEST ACCOUNT",
            "identifier": "STL70408459",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCKESSON SUBMITTER",
            "identifier": "91674",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCKESSON SUBMITTER",
            "identifier": "691674",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1760018774",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dr.jessica.whelan.1@21369.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "301 S Main St",
            "city": "Dupo",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622391325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dr.jessica.whelan.1@21369.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "301 S Main St",
            "city": "Dupo",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622391325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Holon Inclusive Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicholas Michael Dubina, DMD
• Dupo Fire Protection District
• Edp of Illinois P.C
• Hannah Frances Goodson, MS, CF-SLP
• Holon Inclusive Behavioral Health
• John Norman Kimmich, DDS
• Ken Kloess, D.M.D.
• Jennifer R Lane
• Meghan Mercado, CNM
• Dhwani Ankur Patel, DMD

• All providers in Dupo, IL
• Compounding Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.