Timothy W Jennings, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R6N64 Issued in MO

Practice address

2024 Dorsett VLG
Maryland Heights, MO 63043-2208

Phone

(314) 590-0550

NPI assigned

Feb 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

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

Specialty

Family Practice

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health at Home Home Health-St. Louis Home health agency, Saint Louis, MO, CCN 267184
• SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
• SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
• SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200
• St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
• SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tjennings26727@direct-ehr-ssmhc.com

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.

• SSM Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Fenton, MO
  • NPI 1700966207
  Medicare reassignment Care Compare group NPD
• SSM Medical Group Inc.

  • Durable Medical Equipment & Medical Supplies
  • Warrenton, MO
  • NPI 1467997155
  NPD
• SSM Depaul Medical Group, Inc.

  • Family Medicine Physician
  • Florissant, MO
  • NPI 1952312951
  NPD (past)

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

• SSM Health Businesses

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1609840552
  Care Compare affiliation Name & address match
• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Charles, MO
  • NPI 1467521146
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Bridgeton, MO
  • NPI 1598835308
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Lake St Louis, MO
  • NPI 1871665380
  Care Compare affiliation
• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988

  Inpatient rehabilitation facility

  Care Compare affiliation
• St. Lukes Episcopal-Presbyterian Hospital

  • General Acute Care Hospital
  • Chesterfield, MO
  • NPI 1346251543
  Care Compare affiliation

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1548233455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 DORSETT VLG",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630432208",
            "telephone_number": "314-590-0550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12255 De Paul Dr",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442510",
            "country_code": "US",
            "telephone_number": "314-344-7600",
            "fax_number": "314-344-7850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "TIMOTHY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "MOR6N64",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R6N64",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00035725",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tjennings26727@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tjennings26727@direct-ehr-ssmhc.com",
            "address_1": "2024 Dorsett Vlg",
            "city": "Maryland Heights",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630432208",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2024 Dorsett Vlg",
            "city": "Maryland Heights",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630432208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Infinity Home Care LLC
• Institute of Intrapersonal Development, LLC
• John L Jackson, PH.D.
• Amen Jawaid
• Harolyn Jennings-Finger, NURSE PRACTITIONER
• Kerry R Jerke, CNP
• John Jerrolds, PHARMD
• Matthew Jirauch, LCSW, CSACII
• John Martin DDS
• Roderick Quennel Jordan Jr., DMD

• Family Medicine Physician in Maryland Heights, MO
• Providers in Maryland Heights, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.