Jessica Nicole Pelletier, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2022014854 Issued in MO

Practice address

One Hospital Dr
Columbia, MO 65212-0001

Phone

(573) 882-8091

Fax

(573) 884-1902

NPI assigned

Mar 27, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA, MO2 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

Specialty

Emergency Medicine

Education

University of New England, College of Osteo Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Curators of the University of MissouriGroup PAC ID 4486759560, 1,108 clinicians

Ripley Emergency Group LLCGroup PAC ID 1254757446, 35 clinicians

Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Missouri Health Care Hospital, Columbia, MO, CCN 260141
• Moberly Regional Medical Center Hospital, Moberly, MO, CCN 260074
• Carilion Franklin Memorial Hospital Hospital, Rocky Mount, VA, CCN 490089

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpelletier110262@direct.carilionclinic.org

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.

• Ripley Emergency Group, LLC

  • Emergency Medicine Physician
  • Kirksville, MO
  • NPI 1720606023
  Medicare reassignment Care Compare group NPD
• The Curators of the University of Missouri

  • Multi-Specialty Clinic/Center
  • Columbia, MO
  • NPI 1235126921
  Medicare reassignment Care Compare group NPD
• Carilion Medical Center

  dba Carilion Emergency Physicians

  • Emergency Medicine Physician
  • Roanoke, VA
  • NPI 1649423815
  Medicare reassignment Care Compare group NPD
• Carilion Giles Community Hospital

  • Critical Access Hospital
  • Pearisburg, VA
  • NPI 1194718304
  Medicare reassignment NPD
• Carilion Rockbridge Community Hospital

  • Multi-Specialty Clinic/Center
  • Lexington, VA
  • NPI 1174636021
  Medicare reassignment NPD
• Curators of the University of Missouri

  dba University Physicians Specialty Care Associates

  • Durable Medical Equipment & Medical Supplies
  • Columbia, MO
  • NPI 1356963201
  NPD
• Carilion Giles Community Hospital

  • Hospitalist Physician
  • Pearisburg, VA
  • NPI 1023663267
  NPD
• Carilion Giles Community Hospital

  • Durable Medical Equipment & Medical Supplies
  • Galax, VA
  • NPI 1639980493
  NPD
• Carilion Medical Center

  dba Carilion Clinic - DME - Westlake

  • Durable Medical Equipment & Medical Supplies
  • Hardy, VA
  • NPI 1073324810
  NPD
• Carilion Rockbridge Community Hospital

  • Multi-Specialty Clinic/Center
  • Lexington, VA
  • NPI 1750936977
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Curators of the University of Missouri

  dba Capital Region Medical Center

  • General Acute Care Hospital
  • Jefferson City, MO
  • NPI 1174597892
  Care Compare affiliation
• Curators of the University of Missouri

  dba University of Missouri Health Care

  • General Acute Care Hospital
  • Columbia, MO
  • NPI 1699769901
  Care Compare affiliation
• Moberly Hospital Company LLC

  dba Moberly Regional Medical Center

  • General Acute Care Hospital
  • Moberly, MO
  • NPI 1770554305
  Care Compare affiliation
• Carilion Franklin Memorial Hospital

  • General Acute Care Hospital
  • Rocky Mount, VA
  • NPI 1710970918
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1851852347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-882-8091",
            "fax_number": "573-884-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2022014854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200109187",
            "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": "1 Barnes Jewish Hospital Plz",
            "address_2": "Dept Emergency Med",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Emergency Medicine Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.