Individual provider Active NPI

Jessica Ann Thomure, NP

  • Family Nurse Practitioner
  • Ballwin, MO
National Provider Identifier
1902042930
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2001016534 Issued in MO
Practice address
14400 Clayton Rd
Ballwin, MO 63011-2713
Phone
(636) 207-1137
Fax
(314) 748-5919
NPI assigned
Dec 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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 2001016534 MO Primary

Addresses

Primary practice location

14400 Clayton Rd
Ballwin, MO 63011-2713

Mailing address

14400 Clayton Rd
Ballwin, MO 63011-2713
Phone (636) 207-1137

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
I20100901000302 MO Practitioner - Nurse Practitioner 3678697307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Kansas School of Med (KC/Wich/Sal), 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Kansas PAGroup PAC ID 7416043807, 139 clinicians

Practice addresses (Care Compare)

14400 Clayton Rd
Ballwin, MO 63011-2713
Phone (866) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2001016534MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Kansas PA Family CurrentSince Jan 2, 2025 Accepting new patients
Davis, Wright, Berdy, & Suffian PC Past Accepting new patients

Locations

14400 Clayton Rd
Ballwin, MO 63011
Phone (636) 207-1137

3825 S Noland Rd
Independence, MO 64055
Phone (816) 254-6002

8021 Watson Rd
Webster Groves, MO 63119
Phone (314) 963-0398

Organizations & group practices 2

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": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1902042930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14400 CLAYTON RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112713",
            "telephone_number": "636-207-1137",
            "fax_number": "314-748-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14400 CLAYTON RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112713",
            "telephone_number": "636-207-1137",
            "fax_number": "314-748-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMURE",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-22",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2001016534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

Verify at the official NPI Registry.