Active NPI
Wellcare Medicare
- Preferred Provider Organization
- Saint Louis, MO
National Provider Identifier
1649869678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Preferred Provider Organization
- Legal business name
- WELLCARE MEDICARE
- Practice address
- 7700 Forsyth Blvd
Saint Louis, MO 63105-1807 - Phone
- (314) 725-4477
- NPI assigned
- Jan 14, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jacob Cornelius Parker, MD, DO
- Title
- Customer Support
- Phone
- (601) 268-8000
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Management Registered Nurse | 163WP0000X | |||
| Clinical Medical Laboratory | 291U00000X | |||
| Preferred Provider Organization | 305R00000X | Primary | ||
| Pediatric Skilled Nursing Facility | 3140N1450X | |||
| Mail Order Pharmacy | 3336M0002X |
Addresses
Primary practice location
7700 Forsyth Blvd
Saint Louis, MO 63105-1807
Mailing address
7700 Forsyth Blvd
Saint Louis, MO 63105-1807
Phone (314) 725-4477
Other practice location 1
6051 U S Highway 49
Hattiesburg, MS 39401-7201
Phone (601) 288-7000
Other practice location 2
5001 Hardy St
Hattiesburg, MS 39402-1308
Phone (601) 268-8000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12365433061 | Other | MO | CORPORATE OFFICE |
| 8420042213 | Other | MS | ENVISION HEALTHCARE |
| 8420042213 | Other | MS | UNITED HEALTHCARE |
Other names 2
- Merit Health Wesley
- Wellcare
National Provider Directory
National Provider Directory- Tax ID family
- Health Facility Laboratory
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacy
- Hattiesburg, MS
- NPI 1255999835
-
- Private Vehicle
- Honolulu, HI
- NPI 1568095503
-
- Physiological Laboratory
- Honolulu, HI
- NPI 1124585336
-
- Internal Medicine Physician
- Hattiesburg, MS
- NPI 1699366542
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610582400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1762819200000",
"number": "1649869678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7700 FORSYTH BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631051807",
"telephone_number": "314-725-4477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7700 FORSYTH BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631051807",
"telephone_number": "314-725-4477"
}
],
"practiceLocations": [
{
"address_1": "6051 U S Highway 49",
"address_purpose": "LOCATION",
"city": "Hattiesburg",
"state": "MS",
"postal_code": "394017201",
"country_code": "US",
"telephone_number": "601-288-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5001 Hardy St",
"address_purpose": "LOCATION",
"city": "Hattiesburg",
"state": "MS",
"postal_code": "394021308",
"country_code": "US",
"telephone_number": "601-268-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "WELLCARE MEDICARE",
"organizational_subpart": "NO",
"enumeration_date": "2021-01-14",
"last_updated": "2025-11-11",
"certification_date": "2025-11-11",
"status": "A",
"authorized_official_last_name": "PARKER",
"authorized_official_first_name": "JACOB",
"authorized_official_middle_name": "CORNELIUS",
"authorized_official_title_or_position": "CUSTOMER SUPPORT",
"authorized_official_telephone_number": "601-268-8000",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD, DO"
},
"taxonomies": [
{
"code": "163WP0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Registered Nurse, Pain Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": false
},
{
"code": "305R00000X",
"taxonomy_group": "",
"desc": "Preferred Provider Organization",
"state": null,
"license": null,
"primary": true
},
{
"code": "3140N1450X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336M0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Mail Order Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CORPORATE OFFICE",
"identifier": "12365433061",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ENVISION HEALTHCARE",
"identifier": "8420042213",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "8420042213",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Merit Health Wesley",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Wellcare",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.