NPIMap

Individual provider Active NPI

Jennifer Rhae Herndon, P.A

  • Physician Assistant
  • Saint Charles, MO
National Provider Identifier
1629217690
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2009013843 Issued in MO
Practice address
300 1St Capitol Dr
Saint Charles, MO 63301-2844
Phone
(314) 317-0600
Fax
(314) 317-0606
NPI assigned
Feb 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085003430 IL
Physician Assistant 363A00000X 2009013843 MO Primary

Addresses

Primary practice location

300 1St Capitol Dr
Saint Charles, MO 63301-2844

Mailing address

12101 Woodcrest Executive Dr
Suite 210
Saint Louis, MO 63141-5047
Phone (314) 317-0600

Other names 1

  • Ms. Jennifer Rhae Twillman Former name

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
I20090603000538 MO Practitioner - Physician Assistant 8527117035 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

1015 Bowles Ave
Fenton, MO 63026-2394
Phone (636) 496-2000

Hospital & facility affiliations

  • SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081

Merit-based Incentive Payment System (MIPS)

Final score
82.4 of 100Reported as group
Quality
65.6
Improvement activities
40
Cost
71.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085003430ILMDPhysician Assistant
2009013843MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians PC CurrentSince Feb 20, 2021 Accepting new patients
Galen Inpatient Physicians, PC CurrentSince Feb 20, 2021 Accepting new patients
BC Progress Emergency Physicians, LLP Physician Assistant Past Accepting new patients
North County Emergency Physicians, LLP Physician Assistant Past Accepting new patients
BC Missouri Emergency Physicians, LLP Physician Assistant Past Accepting new patients
Hospitalmd of Troy Ip, Inc. Past Accepting new patients
Hospitalmd of Troy, Inc. Past Accepting new patients
BC Missouri Emergency Physicians, LLP Physician Assistant Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

Organizations & group practices 10

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 1

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": "1234483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1629217690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12101 WOODCREST EXECUTIVE DR",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415047",
            "telephone_number": "314-317-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 1ST CAPITOL DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012844",
            "telephone_number": "314-317-0600",
            "fax_number": "314-317-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNDON",
        "first_name": "JENNIFER",
        "middle_name": "RHAE",
        "name_prefix": "Mrs.",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-13",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003430",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2009013843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "TWILLMAN",
            "middle_name": "RHAE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.