Individual provider Active NPI

Jennifer Joy Main, M.A., CCC-A

  • Audiologist
  • Saint Louis, MO
National Provider Identifier
1841378007
Registry record updated Feb 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2012033707 Issued in MO
Practice address
615 S New Ballas Rd
Ste. 385a
Saint Louis, MO 63141-8221
Phone
(314) 251-5850
Fax
(314) 251-6818
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 002117 NY
Audiologist 231H00000X 23002425A IN
Audiologist 231H00000X 2012033707 MO Primary

Addresses

Primary practice location

615 S New Ballas Rd
Ste. 385a
Saint Louis, MO 63141-8221

Mailing address

615 S New Ballas Rd
Ste. 385a
Saint Louis, MO 63141-8221
Phone (314) 251-5850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160810001272 MO Practitioner - Qualified Audiologist 5597868885 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
002117NYMDOccupational Therapist
23002425AINMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Jun 6, 2016 Accepting new patients
St Louis Pathology Assoc Inc. Current Accepting new patients
Mercy Hospital South CurrentSince Jan 1, 2020 Accepting new patients
Mercy Hospitals East Communities Audiologist CurrentSince Jun 6, 2016 Accepting new patients
Mercy Hospitals East Communities Current Accepting new patients
Mercy Hospitals East Communities CurrentSince May 14, 2022 Accepting new patients
Mercy Hospitals East Communities CurrentSince May 14, 2022 Accepting new patients
Mercy Hospital South CurrentSince Jan 1, 2020 Accepting new patients

Locations

12680 Olive Blvd
Ste 210
Saint Louis, MO 63141
Phone (314) 251-5850

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

615 S New Ballas Rd
Ste 385A
Saint Louis, MO 63141
Phone (314) 251-5850

621 S New Ballas Rd
Ste 482
Saint Louis, MO 63141
Phone (314) 251-5850

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

10004 Kennerly Rd
Ste 205A
Saint Louis, MO 63128
Phone (314) 525-4327

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

901 Patients First Dr
Ste 3500
Washington, MO 63090
Phone (636) 390-1570

Organizations & group practices 8

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360281600000",
    "number": "1841378007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "address_2": "STE. 385A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-5850",
            "fax_number": "314-251-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "address_2": "STE. 385A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-5850",
            "fax_number": "314-251-6818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIN",
        "first_name": "JENNIFER",
        "middle_name": "JOY",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2013-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "002117",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002425A",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2012033707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.