Active NPI
Jean R McCammon, MSN, ANP-BC, ACNP-BC
- Nurse Practitioner
- Des Peres, MO
National Provider Identifier
1528000700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 137755
- Practice address
- 13319 Manchester Rd
Des Peres, MO 63131-1710 - Phone
- (314) 822-1060
- NPI assigned
- Jun 12, 2006
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 137755 | MO | Primary |
Addresses
Primary practice location
13319 Manchester Rd
Des Peres, MO 63131-1710
Mailing address
12639 Old Tesson Rd
Suite 115
Saint Louis, MO 63128-2786
Phone (314) 849-0311
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 206587 | Other | MO | BLUE CROSS BLUE SHIELD |
| 733111 | Other | MO | HEALTHLINK |
Other names 1
- Miss Jean M Renfro
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)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Century Emergency Physician of West Virginia Inc | Nurse Practitioner | Past | Accepting new patients |
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.
-
- Emergency Medicine Physician
- Charleston, WV
- NPI 1396722641
Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1528000700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12639 OLD TESSON RD",
"address_2": "SUITE 115",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631282786",
"telephone_number": "314-849-0311",
"fax_number": "314-849-4423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13319 MANCHESTER RD",
"city": "DES PERES",
"state": "MO",
"postal_code": "631311710",
"telephone_number": "314-822-1060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCAMMON",
"first_name": "JEAN",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "MSN, ANP-BC, ACNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-12",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MO",
"license": "137755",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "206587",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "733111",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JEAN",
"last_name": "RENFRO",
"middle_name": "M",
"prefix": "MISS",
"credential": "BSN, RN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Des Peres, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.