Individual provider Active NPI

Jonathan Price, PA

  • Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1548612062
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2020036333 Issued in MO
Practice address
607 S New Ballas Rd Ste 3100
Saint Louis, MO 63141-8219
Phone
(314) 251-8850
NPI assigned
Jul 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 2020036333 MO Primary

Addresses

Primary practice location

607 S New Ballas Rd Ste 3100
Saint Louis, MO 63141-8219

Mailing address

607 S New Ballas Rd Ste 3100
Saint Louis, MO 63141-8219
Phone (314) 251-8850

Other practice location 1

5649 South Highway 125
Rogersville, MO 65742
Phone (417) 300-8960

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210203001754 MO Practitioner - Physician Assistant 5496169401 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortho Missouri LLCGroup PAC ID 8527417229, 7 clinicians

Practice addresses (Care Compare)

11330 Olive Blvd
Suite 150
Creve Coeur, MO 63141-7149
Phone (314) 782-1994

201 S Mount Auburn Rd
Suite C
Cape Girardeau, MO 63703-4912
Phone (573) 381-0780

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2020036333MOMDPhysician Assistant

Organizations & group practices 2

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 2

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": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1548612062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 S NEW BALLAS RD STE 3100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418219",
            "telephone_number": "314-251-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 S NEW BALLAS RD STE 3100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418219",
            "telephone_number": "314-251-8850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5649 South Highway 125",
            "address_purpose": "LOCATION",
            "city": "Rogersville",
            "state": "MO",
            "postal_code": "65742",
            "country_code": "US",
            "telephone_number": "417-300-8960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRICE",
        "first_name": "JONATHAN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-08",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2020036333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.