NPIMap

Individual provider Active NPI

Jerry Lane Lowder, MD

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Saint Louis, MO
National Provider Identifier
1619941879
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
2013044288 Issued in MO
Practice address
4901 Forest Park Ave
Div OBGYN Pelvic Med/Reconstruct Surg, Ste 710
Saint Louis, MO 63108-1495
Phone
(314) 747-1402
Fax
(314) 362-3328
NPI assigned
Feb 15, 2006
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Male
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2013044288 MO
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 2013044288 MO Primary

Addresses

Primary practice location

4901 Forest Park Ave
Div OBGYN Pelvic Med/Reconstruct Surg, Ste 710
Saint Louis, MO 63108-1495

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 747-1402

Other identifiers 1

IdentifierTypeStateIssuer
200011086MedicaidMO

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
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140224000140 MO Practitioner - Obstetrics/Gynecology 1254370844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Brody School of Medicine at East Carolina University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

4901 Forest Park Ave
Suite 710
Saint Louis, MO 63108-1495
Phone (314) 362-7135

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013044288MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University Obstetrics & Gynecology CurrentSince Jan 2, 2014 Accepting new patients
Washington University CurrentSince Jan 2, 2014 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Washington University Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

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

4901 Forest Park Ave
#80643
Saint Louis, MO 63108

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

660 S Euclid Ave
Saint Louis, MO 63110

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

660 S Euclid Ave
#C
Saint Louis, MO 63110

Interoperability endpoints

  • Direct secure messaging: jlowder155701@direct.carenet.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1619941879",
    "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": "314-747-1402",
            "fax_number": "314-362-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 FOREST PARK AVE",
            "address_2": "DIV OBGYN PELVIC MED/RECONSTRUCT SURG, STE 710",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081495",
            "telephone_number": "314-747-1402",
            "fax_number": "314-362-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWDER",
        "first_name": "JERRY",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2013044288",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "MO",
            "license": "2013044288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200011086",
            "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 Pelvic Med/Reconstruct Surg, 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.