Active NPI
Jennie M Austin, MD
- Pediatrics Physician
- Kansas City, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2005031069
- Practice address
- 2401 Gillham Rd
Children's Mercy
Kansas City, MO 64108-4619 - Phone
- (816) 234-3000
- Fax
- (816) 234-3000
- NPI assigned
- Apr 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2005031069 | MO | Primary |
Addresses
Primary practice location
2401 Gillham Rd
Children's Mercy
Kansas City, MO 64108-4619
Mailing address
2401 Gillham Rd
Children'E Mercy
Kansas City, MO 64108-4619
Phone (816) 234-3000
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 440546366 | Other | UNITED HEALTHCARE | |
| 507515500 | Other | MO | MEDICAID |
| 200974 | Other | BLUE CROSS BLUE SHIELD | |
| 204990105 | Medicaid | MO | |
| 721499 | Other | HEALTHLINK | |
| H63439 | Other | MERCY | |
| 204990105 | Other | MO | MEDICAID |
Other names 1
- Jennie M Coe
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005031069 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Medical Group, Inc. | Current | Accepting new patients | |
| SSM Health Care St. Louis | Pediatrics | Past | Accepting new patients |
Locations
300 Medical Plz
Ste 310
Lake St Louis, MO 63367
Phone (314) 291-6556
1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115
Interoperability endpoints
- jaustin88806@direct-ehr-ssmhc.com
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.
-
dba SSM Health Medical Group
- Multi-Specialty Clinic/Center
- Fenton, MO
- NPI 1700966207
-
dba SSM Health St. Joseph Hospital - St. Charles Physician Billing
- Emergency Medicine Physician
- Saint Charles, MO
- NPI 1427002922
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344988800000",
"number": "1659336774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 GILLHAM RD",
"address_2": "CHILDREN'E MERCY",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641084619",
"telephone_number": "816-234-3000",
"fax_number": "816-234-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 GILLHAM RD",
"address_2": "CHILDREN'S MERCY",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641084619",
"telephone_number": "816-234-3000",
"fax_number": "816-234-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUSTIN",
"first_name": "JENNIE",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-20",
"last_updated": "2012-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2005031069",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "440546366",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "507515500",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "200974",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "204990105",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "721499",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY",
"identifier": "H63439",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "204990105",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIE",
"last_name": "COE",
"middle_name": "M",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.