Jenny Myoung Detert, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2019015900 Issued in MO

Practice address

10777 Sunset Office Dr Ste 110
Saint Louis, MO 63127-1019

Phone

(314) 781-7415

NPI assigned

Apr 28, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jdetert1033691@directc.mercy.net

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.

• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1710121272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 PAR LN",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631222938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10777 SUNSET OFFICE DR STE 110",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271019",
            "telephone_number": "314-781-7415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETERT",
        "first_name": "JENNY",
        "middle_name": "MYOUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2019015900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Gabrielle Dessain, MD
• Catherine Deterding
• Theresa Deterding
• Elaine M Deters-Dunn, R.N.
• Sophia C Deters
• Nickolai C Detert, DNP, FNP-C
• Tyler T Detmer, DPT
• Patricia Ann Dettenmeier, MSN CS
• Rachel E Dettleff-Schmidt, LCSW
• Matthew Robert Dettmer, MD

• Pediatrics Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.