Active NPI
Jacquelyn C Schnidman, MD
- Pediatrics Physician
- Saint Louis, MO
National Provider Identifier
1508850462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- R9A43
- Practice address
- 4217 Bayless Ave
Saint Louis, MO 63123-7513 - Phone
- (314) 638-7330
- Fax
- (314) 638-3614
- NPI assigned
- Sep 7, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R9A43 | MO | Primary |
Addresses
Primary practice location
4217 Bayless Ave
Saint Louis, MO 63123-7513
Mailing address
4217 Bayless Ave
Saint Louis, MO 63123-7513
Phone (314) 638-7330
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201779402 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R9A43 | MO | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1508850462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4217 BAYLESS AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631237513",
"telephone_number": "314-638-7330",
"fax_number": "314-638-3614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4217 BAYLESS AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631237513",
"telephone_number": "314-638-7330",
"fax_number": "314-638-3614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHNIDMAN",
"first_name": "JACQUELYN",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-07",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "R9A43",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201779402",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.