Jill C. Kirks

Key facts

NPI

1679616932

Entity type

Individual (NPI type 1)

Primary specialty

Nutritionist 133N00000X

License

2001016638 (MO)

Practice address

1475 Kisker Rd
Saint Charles, MO 63304-8781

Phone

(636) 498-7800

NPI assigned

Feb 15, 2007

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• SSM Health Care St. Louis Emergency Medicine Physician · Saint Charles, MO · NPI 1427002922
  NPD (past)
• SSM Health Care St. Louis Emergency Medical Services (Emergency Medicine) Physician · Lake St Louis, MO · NPI 1538113097
  NPD (past)
• SSM Health Care St. Louis Emergency Medicine Physician · Wentzville, MO · NPI 1588618755
  NPD (past)
• SSM St. Joseph Health Center Registered Dietitian · Saint Charles, MO · NPI 1649426768
  NPD (past)
• SSM St. Joseph Health Center Clinic/Center · Saint Charles, MO · NPI 1982646980
  NPD (past)
• SSM St. Joseph Hospital West Internal Medicine Physician · Warrenton, MO · NPI 1255385456
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679616932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 LACKLAND HILL PKWY",
            "address_2": "ATTN CREDENTIALING DEPT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463572",
            "telephone_number": "314-989-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 KISKER RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633048781",
            "telephone_number": "636-498-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKS",
        "first_name": "JILL",
        "middle_name": "C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MO",
            "license": "2001016638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

• Rachael King, RD
• Abigail Viola Kinnear
• Kaitlyn Marie Kirby, LPN
• Kayla Dawn Kirkland, LPC
• Kirkpatricks in Home Care, LLC
• Rachel Kathleen Kitzmann, PA-C
• Bryce Lane Klein, M. ED.
• KLG Counseling, Inc.
• Cindy Klimaszewski
• Katherine Marjorie Kline, PH.D.

All providers in Saint Charles, MO · Nutritionist in Missouri