Individual provider Active NPI

Damithri N Jenkins

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1831846500
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2022002465 Issued in MO
Practice address
4921 Parkview PL
Saint Louis, MO 63110-1032
Phone
(314) 747-7796
Fax
(314) 286-0745
NPI assigned
Mar 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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 2022002465 MO Primary

Addresses

Primary practice location

4921 Parkview PL
Saint Louis, MO 63110-1032

Mailing address

4921 Parkview PL
Saint Louis, MO 63110-1032
Phone (314) 747-7796

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
I20231206000279 MO Practitioner - Nurse Practitioner 6002280526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

16555 Manchester Rd
Suite 100
Wildwood, MO 63040-1220
Phone (636) 458-0646

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Oct 31, 2023 Accepting new patients

Locations

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

16555 Manchester Rd
Ste 100
Wildwood, MO 63040
Phone (636) 458-0646

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.

Hospital & facility affiliations 3

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": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1831846500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-747-7796",
            "fax_number": "314-286-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-747-7796",
            "fax_number": "314-286-0745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "DAMITHRI",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2022002465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.