Individual provider Active NPI

Abigail Lee Jerauld, APRN-CNP

  • Neonatal Intensive Care Registered Nurse
  • Saint Louis, MO
National Provider Identifier
1922430248
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Intensive Care Registered NurseTaxonomy code 163WN0002X
License
2005027592 Issued in MO
Practice address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone
(314) 577-5631
NPI assigned
Aug 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 2005027592 MO Primary

Addresses

Primary practice location

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Mailing address

608 Old State Place Dr
Wildwood, MO 63038-2320
Phone (636) 236-4637

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ajerauld110810@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005027592MOMDNeonatal Intensive Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1922430248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 OLD STATE PLACE DR",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630382320",
            "telephone_number": "636-236-4637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERAULD",
        "first_name": "ABIGAIL",
        "middle_name": "LEE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "MO",
            "license": "2005027592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajerauld110810@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ajerauld110810@direct-ehr-ssmhc.com",
            "address_1": "1465 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1465 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.