Individual provider Active NPI

Lauren Elizabeth Jones, DO

  • Pediatrics Physician
  • Fenton, MO
National Provider Identifier
1477084564
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2020033533 Issued in MO
Practice address
714 Gravois Rd
Ste 200
Fenton, MO 63026-7766
Phone
(636) 349-5437
Fax
(636) 349-6663
NPI assigned
Mar 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2020033533 MO Primary

Addresses

Primary practice location

714 Gravois Rd
Ste 200
Fenton, MO 63026-7766

Mailing address

PO Box 7412053
Chicago, IL 60674-2053
Phone (636) 349-5437

Other identifiers 1

IdentifierTypeStateIssuer
200045918MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230901001719 MO Practitioner - Pediatric Medicine 2668744103 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wuca-Fenton Pediatrics, LLC Pediatrics CurrentSince Aug 28, 2023 Accepting new patients

Locations

714 Gravois Rd
Ste 200
Fenton, MO 63026
Phone (636) 349-5437

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1477084564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412053",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742053",
            "telephone_number": "636-349-5437",
            "fax_number": "636-349-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 GRAVOIS RD",
            "address_2": "STE 200",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267766",
            "telephone_number": "636-349-5437",
            "fax_number": "636-349-6663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2025-04-18",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2020033533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200045918",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "714 Gravois Rd",
            "address_2": "STE 200",
            "city": "Fenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630267766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.