Individual provider Active NPI

Jennifer Schallert, NP

  • Nurse Practitioner
  • O Fallon, MO
National Provider Identifier
1932481884
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2011013781 Issued in MO
Practice address
1101 Highway K
O Fallon, MO 63366-8431
Phone
(636) 379-6363
Fax
(636) 379-0584
NPI assigned
Sep 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2011013781 MO Primary

Addresses

Primary practice location

1101 Highway K
O Fallon, MO 63366-8431

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534

Other identifiers 1

IdentifierTypeStateIssuer
2011013781OtherMOMO LICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jschallert43539@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
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
I20120210000286 MO Practitioner - Nurse Practitioner 7719144252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

1101 Hwy K
O Fallon, MO 63366-8431
Phone (636) 379-6363

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group, Inc. CurrentSince Aug 1, 2018 Accepting new patients

Locations

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1101 Highway K
O Fallon, MO 63366
Phone (636) 379-6347

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

Interoperability endpoints

  • Direct secure messaging: jschallert43539@direct-ehr-ssmhc.com

Organizations & group practices 1

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": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1932481884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633668431",
            "telephone_number": "636-379-6363",
            "fax_number": "636-379-0584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHALLERT",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-16",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2011013781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO LICENSE",
            "identifier": "2011013781",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jschallert43539@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jschallert43539@direct-ehr-ssmhc.com",
            "address_1": "1101 Highway K",
            "city": "O Fallon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633668431",
            "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": "1101 Highway K",
            "city": "O Fallon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633668431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

Verify at the official NPI Registry.