Individual provider Active NPI

Jessica Marie Knobbe, CPNP

  • Pediatric Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1780409805
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
2024047471 Issued in MO
Practice address
5501 Delmar Blvd Ste B560
Saint Louis, MO 63112-3084
Phone
(314) 833-4030
NPI assigned
Nov 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 2024047471 MO Primary

Addresses

Primary practice location

5501 Delmar Blvd Ste B560
Saint Louis, MO 63112-3084

Mailing address

5501 Delmar Blvd
Saint Louis, MO 63112-3054
Phone (314) 833-4030

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
I20241220002904 MO Practitioner - Nurse Practitioner 9739616384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Institute for Research and Education in Family MedicineGroup PAC ID 6608833587, 9 clinicians

Practice addresses (Care Compare)

9417 S Broadway
Saint Louis, MO 63125-2009
Phone (314) 833-4030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024047471MOMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Research and Education in Family Medicine CurrentSince Jan 1, 2025 Accepting new patients

Locations (25 of 36)

11280 Saint Charles Rock Rd
Bridgeton, MO 63044

11635 Oakbury Ct
Bridgeton, MO 63044
Phone (314) 213-8012

3415 Bridgeland Dr
Bridgeton, MO 63044

11300 Saint Charles Rock Rd
Bridgeton, MO 63044
Phone (314) 739-6811

1700 Derhake Rd
Florissant, MO 63033
Phone (314) 989-7600

2497 Creve Coeur Mill Rd
Maryland Heights, MO 63043
Phone (314) 213-8051

102 Fee Fee Rd
Maryland Heights, MO 63043
Phone (314) 213-8016

2905 Rose Acres Ln
Maryland Heights, MO 63043
Phone (314) 213-8017

3199 Parkwood Ln
Maryland Heights, MO 63043

195 Fee Fee Rd
Maryland Heights, MO 63043
Phone (314) 213-8033

2900 Adie Rd
Saint Ann, MO 63074
Phone (314) 213-8100

11055 Saint Charles Rock Rd
Saint Ann, MO 63074
Phone (314) 213-8032

3721 Saint Bridget Ln
Saint Ann, MO 63074
Phone (314) 213-8419

315 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 947-0600

516 Jefferson St
Saint Charles, MO 63301
Phone (636) 946-0101

5501 Delmar Blvd
Ste B560
Saint Louis, MO 63112

1547 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 776-3285

7520 Natural Bridge Rd
Saint Louis, MO 63121
Phone (314) 222-4877

11022 Schuetz Rd
Saint Louis, MO 63146
Phone (314) 213-8018

3001 Meramec St
Saint Louis, MO 63118
Phone (314) 631-2470

11037 Breezy Point Ln
Saint Louis, MO 63136
Phone (314) 953-8041

3230 Hartford St
Saint Louis, MO 63118
Phone (314) 776-6040

7401 Florissant Rd
Saint Louis, MO 63121
Phone (314) 261-6011

4222 Delor St
Saint Louis, MO 63116
Phone (314) 773-6100

5183 Raymond Ave
Saint Louis, MO 63113

Organizations & group practices 1

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": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1780409805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631123054",
            "telephone_number": "314-833-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 DELMAR BLVD STE B560",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631123084",
            "telephone_number": "314-833-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOBBE",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2024047471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.