Individual provider Active NPI

Jeannie Chen Kelly, MD

  • Maternal & Fetal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1730316761
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
2016014394 Issued in MO
Practice address
4901 Forest Park Ave
Div OBGYN MFM and US, Ste 710
Saint Louis, MO 63108-1495
Phone
(314) 454-8181
Fax
(314) 747-1429
NPI assigned
Jun 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2016014394 MO
Maternal & Fetal Medicine Physician 207VM0101X 2016014394 MO Primary

Addresses

Primary practice location

4901 Forest Park Ave
Div OBGYN MFM and US, Ste 710
Saint Louis, MO 63108-1495

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 454-8181

Other identifiers 1

IdentifierTypeStateIssuer
200031874MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160727000172 MO Practitioner - Obstetrics/Gynecology 0749420495 Reassigns benefits to 3 organizations
I20161103001068 IL Practitioner - Obstetrics/Gynecology 0749420495 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Columbia University College of Physicians and Surgeons, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians
Miracl LLCGroup PAC ID 4587908041, 96 clinicians

Practice addresses (Care Compare)

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone (314) 747-3000

1000 W 10TH St
Phelps Health
Rolla, MO 65401-2905
Phone (573) 364-9000

1050 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-9000

1060 W 10TH St
Phelps Health Delbert Day Cancer Institute
Rolla, MO 65401-2905
Phone (855) 406-3324

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-6000

3023 N Ballas Rd
Suite 450
Saint Louis, MO 63131-2358
Phone (314) 996-6000

4901 Forest Park Ave
Saint Louis, MO 63108-1495

660 S Euclid Ave
St Louis, MO 63110-1010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.01 of 100Reported as group
Quality
76.14
Promoting interoperability
99
Improvement activities
40
Cost
76.43

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University Physicians in Illinois, Inc. CurrentSince Sep 1, 2018 Accepting new patients
Heartland Women'S Healthcare LTD CurrentSince Jan 1, 2020 Accepting new patients
Washington University Physicians in Illinois, Inc CurrentSince Sep 1, 2018 Accepting new patients
Washington University CurrentSince Jul 1, 2016 Accepting new patients
Heartland Women'S Healthcare LTD Obstetrics & Gynecology CurrentSince Jan 1, 2020 Accepting new patients
Washington University Physicians in Illinois, Inc Current Accepting new patients
Washington University Obstetrics & Gynecology CurrentSince Jul 1, 2016 Accepting new patients
Miracl, LLC CurrentSince Feb 20, 2025 Accepting new patients
Fairview Heights Medical Group SC Past Accepting new patients
Washington University Past Accepting new patients
Barnes Jewish Hospital Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

900 E Walnut St
Ste 10
Carbondale, IL 62901

2016 Vadalabene Dr
Maryville, IL 62062
Phone (618) 288-2970

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

660 S Euclid Ave
#C
Saint Louis, MO 63110

4240 Duncan Ave
Ste 301
Saint Louis, MO 63110

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

3023 N Ballas Rd
Ste 450D
Saint Louis, MO 63131
Phone (314) 286-2400

660 S Euclid Ave
Saint Louis, MO 63110

4901 Forest Park Ave
Ste 710
Saint Louis, MO 63108
Phone (314) 362-4211

1 Barnes Jew Hosp Plz
Saint Louis, MO 63110
Phone (314) 362-2462

660 S Euclid Ave
#8064
Saint Louis, MO 63110
Phone (314) 747-8274

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: jkelly133036@direct.carenet.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1730316761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-454-8181",
            "fax_number": "314-747-1429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 FOREST PARK AVE",
            "address_2": "DIV OBGYN MFM AND US, STE 710",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081495",
            "telephone_number": "314-454-8181",
            "fax_number": "314-747-1429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JEANNIE",
        "middle_name": "CHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2016014394",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "MO",
            "license": "2016014394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200031874",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4901 Forest Park Ave",
            "address_2": "Div OBGYN MFM and US, Ste 710",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631081495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.