Individual provider Active NPI

Jaclyn C Hey

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1700214608
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2013038962 Issued in MO
Practice address
711 Old Ballas Rd Ste 100
Saint Louis, MO 63141-7068
Phone
(314) 569-0510
Fax
(314) 569-1085
NPI assigned
Oct 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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 2013038962 MO Primary

Addresses

Primary practice location

711 Old Ballas Rd Ste 100
Saint Louis, MO 63141-7068

Mailing address

711 Old Ballas Rd Ste 100
Saint Louis, MO 63141-7068
Phone (314) 569-0510

Other names 1

  • Jaclyn C Rapp Former name

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
I20140307000238 MO Practitioner - Nurse Practitioner 6901036227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allergy and Asthma Consultants, PCGroup PAC ID 9032386974, 3 clinicians

Practice addresses (Care Compare)

711 Old Ballas Rd
Suite 100
Creve Coeur, MO 63141-7068
Phone (314) 569-0510

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1700214608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 OLD BALLAS RD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417068",
            "telephone_number": "314-569-0510",
            "fax_number": "314-569-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 OLD BALLAS RD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417068",
            "telephone_number": "314-569-0510",
            "fax_number": "314-569-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEY",
        "first_name": "JACLYN",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-31",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013038962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "RAPP",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.