Individual provider Active NPI

Jolene Marie Cabral, FNP

  • Family Nurse Practitioner
  • Festus, MO
National Provider Identifier
1659988517
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2020022257 Issued in MO
Practice address
1390 US Highway 61 Ste N1500
Festus, MO 63028-4137
Phone
(636) 933-5055
NPI assigned
Sep 24, 2020
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2020022257 MO Primary

Addresses

Primary practice location

1390 US Highway 61 Ste N1500
Festus, MO 63028-4137

Mailing address

1390 US Highway 61 Ste N1500
Festus, MO 63028-4137
Phone (636) 933-5055

Other practice location 1

550 Maple Valley Dr
Farmington, MO 63640-1981
Phone (636) 933-5055

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address SouthStLouisMedicalAssociatesLLC.JoleneCabral@119671.advancedmd-direct.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201014002596 MO Practitioner - Nurse Practitioner 0244650133 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Heart and Vascular LLCGroup PAC ID 8820016207, 112 clinicians

Practice addresses (Care Compare)

1390 US Hwy 61
Suite N1500
Festus, MO 63028-4137
Phone (636) 933-5055

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2020022257MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South St Louis Medical Associates LLC CurrentSince Sep 30, 2020 Accepting new patients
Mercy Clinic Heart and Vascular, LLC CurrentSince Aug 4, 2024 Accepting new patients
Mercy Clinic Cardiovascular and Thoracic Surgery, LLC Past Accepting new patients

Locations

1390 US Highway 61
Ste N1500
Crystal Cty, MO 63028
Phone (636) 933-5055

550 Maple Valley Dr
Farmington, MO 63640
Phone (573) 454-2466

10012 Kennerly Rd
Ste 202
Saint Louis, MO 63128
Phone (314) 692-2807

3915 Watson Rd
Ste 100
Saint Louis, MO 63109
Phone (314) 646-0478

625 S New Ballas Rd
Ste 2015
Saint Louis, MO 63141
Phone (314) 251-1775

901 Patients First Dr
#2500
Washington, MO 63090

Interoperability endpoints

  • Direct secure messaging: southstlouismedicalassociatesllc.jolenecabral@119671.advancedmd-direct.com

Organizations & group practices 3

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 5

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": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1659988517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 US HIGHWAY 61 STE N1500",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284137",
            "telephone_number": "636-933-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 US HIGHWAY 61 STE N1500",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284137",
            "telephone_number": "636-933-5055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Maple Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "MO",
            "postal_code": "636401981",
            "country_code": "US",
            "telephone_number": "636-933-5055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CABRAL",
        "first_name": "JOLENE",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020022257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SouthStLouisMedicalAssociatesLLC.JoleneCabral@119671.advancedmd-direct.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3915 Watson Rd Ste 100",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631091251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.