Jodi Green, ARNP
Individual provider Active NPI Family Nurse Practitioner · High Ridge, MO
NPI 1679730576 · NPPES record last updated May 19, 2008
Key facts
- NPI
- 1679730576
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 152741 (MO)
- Practice address
- 1000 Crossroads PL
High Ridge, MO 63049-2234 - Phone
- (866) 825-3227
- Fax
- (484) 450-2617
- NPI assigned
- May 19, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Medicine - SLMG South LLC
Emergency Physicians of St Lukes LLC
Premier Medical Physicians LLC
Practice addresses (Care Compare)
103 Hilltop TRL
Eureka, MO 63025-3172
Phone (636) 587-6350
12304 Manchester Rd
Des Peres, MO 63131-4315
Phone (314) 965-6871
2325 Dougherty Ferry Rd
Suite 104
Saint Louis, MO 63122-3356
Phone (314) 821-6889
233 Clarkson Rd
Ellisville, MO 63011-2219
Phone (636) 256-8644
Hospital & facility affiliations
- St Lukes Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.71 of 100
- Quality
- 82.25
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080826000303 | MO | Practitioner - Nurse Practitioner | 1153496179 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Medicine - SLMG South, LLC | Current |
Accepting new patients | |
| Emergency Physicians of St. Luke'S, LLC | Current |
Accepting new patients | |
| Premier Medical Physicians LLC | Current |
Accepting new patients | |
| Take Care Health Missouri, PC | Family | Past | Accepting new patients |
| St. Lukes Medical Group | Past | Accepting new patients |
Locations
121 Saint Lukes Center Dr
Chesterfield, MO 63017
Phone (314) 434-3278
12304 Manchester Rd
Des Peres, MO 63131
Phone (314) 965-6871
233 Clarkson Rd
Ellisville, MO 63011
Phone (636) 256-8644
103 Hilltop Village Center Dr
Eureka, MO 63025
Phone (314) 576-9797
1501 Professional Dr
Imperial, MO 63052
Phone (636) 464-4000
2325 Dougherty Ferry Rd
Ste 104
Saint Louis, MO 63122
Phone (314) 821-6889
232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 152741 | MO | Yes |
Addresses
Primary practice location
1000 Crossroads PL
High Ridge, MO 63049-2234
Mailing address
161 Washington St
Eight Tower Bridge, Suite 1400
Conshohocken, PA 19428-2083
Phone (866) 825-3227
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 152741 | Other | MO | LICENSE |
Other providers in High Ridge, MO
- Kelly Friedmeyer
- G.M. Sontag, Inc.
- Teresa L Galeotti
- Jimmy L Garrison
- Anthony Graf
- Elizabeth Ann Grothe
- Natalie Haffner
- Ann Hawkins
- Danielle Hawkins
- Heart and Home Care, LLC
All providers in High Ridge, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.