Individual provider Active NPI

Jeanne M Hancock, FNP

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1972696730
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
079419 Issued in MO
Practice address
3933 S Broadway
Saint Louis, MO 63118-4601
Phone
(314) 865-7000
Fax
(314) 865-7073
NPI assigned
Oct 2, 2006
Last updated
Sep 10, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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 079419 MO Primary

Addresses

Primary practice location

3933 S Broadway
Saint Louis, MO 63118-4601

Mailing address

200 Collinsville Ave
Collinsville, IL 62234-2407
Phone (618) 345-4265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040624000875 MO Practitioner - Nurse Practitioner 9830175686 Reassigns benefits to 3 organizations
I20090527000397 IL Practitioner - Nurse Practitioner 9830175686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Services Midwest SCGroup PAC ID 2769746056, 37 clinicians

Practice addresses (Care Compare)

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 257-5644

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Services of Memphis, P.C. Nurse Practitioner CurrentSince Sep 1, 2015 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Nurse Practitioner CurrentSince Aug 1, 2024 Accepting new patients
Our Urgent Care, LLC CurrentSince Dec 9, 2019 Accepting new patients
Mo Cardinals Emergency Physicians, LLC Past Accepting new patients
Saint Louis Connectcare Past Accepting new patients
St Alexius Emergency Physicians LLC Past Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

2070 McKelvey Rd
Maryland Hts, MO 63043
Phone (314) 309-3562

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252540800000",
    "number": "1972696730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 COLLINSVILLE AVE",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622342407",
            "telephone_number": "618-345-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3933 S BROADWAY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631184601",
            "telephone_number": "314-865-7000",
            "fax_number": "314-865-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "JEANNE",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2009-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "079419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.