NPIMap

Individual provider Active NPI

Jacob Peyton, M.D.

  • Obstetrics & Gynecology Physician
  • Festus, MO
National Provider Identifier
1912293010
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2015012713 Issued in MO
Practice address
1400 US Highway 61
Suite 340
Festus, MO 63028-4100
Phone
(636) 937-1545
Fax
(636) 937-8995
NPI assigned
Jun 27, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2011019436 MO
Obstetrics & Gynecology Physician 207V00000X 2015012713 MO Primary

Addresses

Primary practice location

1400 US Highway 61
Suite 340
Festus, MO 63028-4100

Mailing address

1400 US Highway 61
Suite 340
Festus, MO 63028-4100
Phone (636) 937-1545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150721001620 MO Practitioner - Obstetrics/Gynecology 4486874989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Texas Southwestern Medical School at Dallas, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, shared by 6 NPIs, 573 clinicians

Practice addresses (Care Compare)

1400 US Hwy 61
Suite 340
Festus, MO 63028-4141
Phone (636) 937-1545

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011019436MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Obstetrics & Gynecology CurrentSince Jul 13, 2015 Accepting new patients
Mercy Clinic East Communities Obstetrics & Gynecology Current Accepting new patients
Mercy Clinic East Communities CurrentSince Jul 13, 2015 Accepting new patients
Mercy Hospital Jefferson Past Accepting new patients

Locations

1400 US Highway 61
Ste 340
Crystal Cty, MO 63028
Phone (314) 937-1545

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

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

Interoperability endpoints

  • Direct secure messaging: jpeyton208591@directc.mercy.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercy Hospital JeffersonFestus, MO, CCN 26T023 Hospital Operational/Managerial Control Jul 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1912293010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61",
            "address_2": "SUITE 340",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284100",
            "telephone_number": "636-937-1545",
            "fax_number": "636-937-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61",
            "address_2": "SUITE 340",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284100",
            "telephone_number": "636-937-1545",
            "fax_number": "636-937-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEYTON",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2011019436",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2015012713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.