Individual provider Active NPI

Jessica Elaine Henke, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1497201057
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2020001589 Issued in MO
Practice address
4320 Forest Park Ave
Ste 1100
Saint Louis, MO 63108-2979
Phone
(314) 333-4100
Fax
(314) 333-4115
NPI assigned
Sep 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2020001589 MO Primary

Addresses

Primary practice location

4320 Forest Park Ave
Ste 1100
Saint Louis, MO 63108-2979

Mailing address

PO Box 7412037
Chicago, IL 60674-2037
Phone (314) 333-4100

Other identifiers 1

IdentifierTypeStateIssuer
420080826MedicaidMO

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 IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161006001325 IL Practitioner - Nurse Practitioner 5193013191 Reassigns benefits to 5 organizations
I20200322000071 MO Practitioner - Nurse Practitioner 5193013191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4320 Forest Park Ave
Suite 1100
Saint Louis, MO 63108-2979
Phone (314) 333-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
75.54

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2020001589MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wood River Urgent Care and Walk in Clinic Inc CurrentSince Nov 4, 2024 Accepting new patients
Belleville Urgent Care Walk-in Clinic CurrentSince Nov 4, 2024 Accepting new patients
Waterloo Urgent Care Walk in Clinic Company CurrentSince Nov 4, 2024 Accepting new patients
Granite City Urgent Care Walk-in Clinic CurrentSince Nov 4, 2024 Accepting new patients
Washington University CurrentSince Mar 1, 2020 Accepting new patients
Washington University Clinical Associates LLC CurrentSince Mar 1, 2020 Accepting new patients
Alton Urgent Care Walk in Clinic Company CurrentSince Nov 4, 2024 Accepting new patients

Locations

1417 Washington Ave
Alton, IL 62002
Phone (618) 260-0320

2801 W Main St
Belleville, IL 62226
Phone (618) 234-3053

2861 Madison Ave
Granite City, IL 62040
Phone (618) 709-7723

907 N Illinois Route 3
Waterloo, IL 62298
Phone (618) 350-0200

211 Madison Ave
Wood River, IL 62095
Phone (618) 709-7723

14671 Telegraph Rd
Redford, MI 48239
Phone (313) 387-2100

4320 Forest Park Ave
Ste 1100
Saint Louis, MO 63108
Phone (314) 333-4100

4921 Parkview Pl
Ste 13A
Saint Louis, MO 63110
Phone (314) 333-4100

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1497201057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412037",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742037",
            "telephone_number": "314-333-4100",
            "fax_number": "314-333-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 FOREST PARK AVE",
            "address_2": "STE 1100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082979",
            "telephone_number": "314-333-4100",
            "fax_number": "314-333-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKE",
        "first_name": "JESSICA",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020001589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420080826",
            "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": "4320 Forest Park Ave",
            "address_2": "Ste 1100",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631082979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.