Individual provider Active NPI

Sherri Lynne Jackson, MD

  • Maternal & Fetal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1578590642
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
2011004655 Issued in MO
Practice address
4901 Forest Park Ave
Div OBGYN MFM and US, Ste 710
Saint Louis, MO 63108-1495
Phone
(314) 454-8181
Fax
(314) 747-1429
NPI assigned
Jun 26, 2006
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
Maternal & Fetal Medicine Physician 207VM0101X 2011004655 MO Primary

Addresses

Primary practice location

4901 Forest Park Ave
Div OBGYN MFM and US, Ste 710
Saint Louis, MO 63108-1495

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 454-8181

Other identifiers 1

IdentifierTypeStateIssuer
205645203MedicaidMO

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 MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110921000604 MO Practitioner - Obstetrics/Gynecology 3072784164 Reassigns benefits to 3 organizations
I20220927001806 IL Practitioner - Obstetrics/Gynecology 3072784164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Missouri, Kansas City, School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians
Miracl LLCGroup PAC ID 4587908041, 96 clinicians

Practice addresses (Care Compare)

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone (314) 286-2400

1000 W 10TH St
Phelps Health
Rolla, MO 65401-2905
Phone (573) 364-9000

1050 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-9000

1060 W 10TH St
Phelps Health Delbert Day Cancer Institute
Rolla, MO 65401-2905
Phone (855) 406-3324

1414 Cross St
Shiloh, IL 62269-2941
Phone (314) 454-5437

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-6000

3023 N Ballas Rd
Suite 450
Saint Louis, MO 63131-2358
Phone (314) 996-6000

4901 Forest Park Ave
Saint Louis, MO 63108-1495

660 S Euclid Ave
St Louis, MO 63110-1010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.01 of 100Reported as group
Quality
76.14
Promoting interoperability
99
Improvement activities
40
Cost
76.43

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University Physicians in Illinois, Inc Current Accepting new patients
Washington University Physicians in Illinois, Inc CurrentSince Aug 2, 2022 Accepting new patients
Washington University Physicians in Illinois, Inc. CurrentSince Aug 2, 2022 Accepting new patients
Washington University CurrentSince Aug 1, 2022 Accepting new patients
Miracl, LLC CurrentSince Jan 16, 2025 Accepting new patients
Washington University Obstetrics & Gynecology CurrentSince Aug 1, 2022 Accepting new patients
Washington University Past Accepting new patients

Locations

1414 Cross St
Ste 140B
O Fallon, IL 62269

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

20 Progress Point Pkwy
Ste 126
O Fallon, MO 63368
Phone (314) 690-8383

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

660 S Euclid Ave
#8064
Saint Louis, MO 63110
Phone (314) 747-8274

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

3023 N Ballas Rd
Ste 450D
Saint Louis, MO 63131
Phone (314) 286-2400

660 S Euclid Ave
Saint Louis, MO 63110

4901 Forest Park Ave
Ste 710
Saint Louis, MO 63108
Phone (314) 362-4211

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-1700

4901 Forest Park Ave
Ste 341
Saint Louis, MO 63108
Phone (314) 454-7882

Organizations & group practices 8

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 3

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1578590642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-454-8181",
            "fax_number": "314-747-1429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 FOREST PARK AVE",
            "address_2": "DIV OBGYN MFM AND US, STE 710",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081495",
            "telephone_number": "314-454-8181",
            "fax_number": "314-747-1429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHERRI",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "MO",
            "license": "2011004655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205645203",
            "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": "4901 Forest Park Ave",
            "address_2": "Div OBGYN MFM and US, Ste 710",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631081495",
            "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.