Individual provider Active NPI

Jordan Charles Nepute, MD

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1821438607
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD0000058745 Issued in TN
Practice address
10010 Kennerly Rd
Saint Louis, MO 63128
Phone
(314) 525-4481
NPI assigned
Jun 26, 2013
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 58745 TN
Diagnostic Radiology Physician 2085R0202X MD466288 PA
Diagnostic Radiology Physician 2085R0202X 2018005762 MO
Diagnostic Radiology Physician 2085R0202X MD0000058745 TN Primary

Addresses

Primary practice location

10010 Kennerly Rd
Saint Louis, MO 63128

Mailing address

11475 Olde Cabin Rd Ste 200
Saint Louis, MO 63141-7129
Phone (314) 991-8210

Other practice location 1

1402 S Grand Blvd Rm M260
Saint Louis, MO 63104-1004
Phone (314) 977-9853

Other practice location 2

16091 Swingley Ridge Rd Ste 100
Chesterfield, MO 63017-2056
Phone (877) 588-3627 ext. 266

Other practice location 3

12735 Wynfield Pines Ct
Saint Louis, MO 63131-2156
Phone (314) 307-1824

Other identifiers 1

IdentifierTypeStateIssuer
Q047642MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, PA, TN3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190131002103 MO Practitioner - Diagnostic Radiology 2961704382 Reassigns benefits to 9 organizations
I20190410002169 PA Practitioner - Diagnostic Radiology 2961704382 Reassigns benefits to 2 organizations
I20190806000961 TN Practitioner - Diagnostic Radiology 2961704382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Saint Louis University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West County Radiological Group IncGroup PAC ID 8527966944, 105 clinicians
Missouri Delta Medical CenterGroup PAC ID 1355252891, 134 clinicians
Vanderbilt University Medical CenterGroup PAC ID 5092023416, 3,510 clinicians
Memphis Physicians Radiological Group PCGroup PAC ID 9830123736, 79 clinicians
Savannah Chatham Imaging LLCGroup PAC ID 6800890245, 32 clinicians
USA Radiology Management Solutions LLCGroup PAC ID 3577780337, 26 clinicians
USA Radiology of Pennsylvania LLCGroup PAC ID 0345594388, 22 clinicians

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1165

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600

11 Fairlane Rd
Reading, PA 19606-9567
Phone (610) 378-8810

12735 Wynfield Pines CT
Saint Louis, MO 63131-2156
Phone (615) 322-5000

1301 Medical Ctr Dr
Nashville, TN 37232-0028
Phone (615) 322-5000

2752 Century Blvd
Wyomissing, PA 19610-3345
Phone (610) 372-8031

5959 Park Ave
Memphis, TN 38119-5200
Phone (901) 765-2191

7037 Lindenwood PL
Saint Louis, MO 63109-1114
Phone (314) 238-5260

751 Liberty St
Meadville, PA 16335-2559
Phone (814) 333-5140

946 E Reed
Hayti, MO 63851
Phone (314) 821-8055

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000058745TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vanderbilt University Medical Center Diagnostic Radiology CurrentSince Jul 1, 2023 Accepting new patients
Memphis Physicians Radiological Group PC Diagnostic Radiology CurrentSince Feb 1, 2023 Accepting new patients
Surgical Institute of Reading LLC Diagnostic Radiology CurrentSince Mar 17, 2020 Accepting new patients
Pemiscot County Memorial Hospital CurrentSince Mar 2, 2021 Accepting new patients
Missouri Delta Medical Center CurrentSince Mar 1, 2025 Accepting new patients
Missouri Delta Medical Center CurrentSince Mar 1, 2025 Accepting new patients
Pemiscot County Memorial Hospital CurrentSince Mar 2, 2021 Accepting new patients
Savannah Chatham Imaging LLC Diagnostic Radiology CurrentSince May 1, 2020 Accepting new patients
Lauderdale Community Hospital LLC Past Accepting new patients

Locations

Dept A T 40379
Atlanta, GA 31192

Dept AT 40379
Atlanta, GA 31192

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

10 Little Brook Rd
West Wareham, MA 02576

16091 Swingley Ridge Rd
Ste 100
Chesterfield, MO 63017
Phone (636) 728-2222

946 E Reed St
Hayti, MO 63851
Phone (573) 359-3408

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

11 Fairlane Rd
Reading, PA 19606
Phone (610) 378-8810

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

1301 Medical Center Dr
Nashville, TN 37232
Phone (615) 343-4882

719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485

1801 N Jackson St
Tullahoma, TN 37388
Phone (931) 393-3000

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1821438607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11475 OLDE CABIN RD STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417129",
            "telephone_number": "314-991-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63128",
            "telephone_number": "314-525-4481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1402 S Grand Blvd Rm M260",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041004",
            "country_code": "US",
            "telephone_number": "314-977-9853",
            "fax_number": "314-977-9852",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16091 Swingley Ridge Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630172056",
            "country_code": "US",
            "telephone_number": "877-588-3627 x266",
            "fax_number": "636-519-7965",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12735 Wynfield Pines Ct",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631312156",
            "country_code": "US",
            "telephone_number": "314-307-1824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEPUTE",
        "first_name": "JORDAN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "TN",
            "license": "58745",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD466288",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2018005762",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "MD0000058745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q047642",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.