RENITRA JACKSON FNP
NPI 1144399270
Nurse Practitioner - Family in Hazelwood, MO

Q: What is Renitra Jackson's NPI number?

The NPI number for Renitra Jackson is 1144399270. It was assigned to this individual provider in the NPPES registry on November 6, 2006.

Q: What is Renitra Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Renitra Jackson was last updated on August 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 06, 2006PECOS EnrolledAccepts Medicare Assignment

637 DUNN RD STE 102A, HAZELWOOD, MO 63042(314) 831-8600(314) 839-5596 Get Directions Write a Review

NPPES record last updated: August 16, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 16, 2024, Apr 16, 2024, Mar 8, 2023 and 1 more (4 updates tracked since 2019).

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About Renitra Jackson Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RENITRA JACKSON FNP (NPI 1144399270) is an individual family provider in Hazelwood, Missouri, licensed in Missouri (2000164715) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS, is affiliated with Mercy Hospital St Louis, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1144399270

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameRENITRA JACKSONCredential: FNP

Location Address637 DUNN RD STE 102AHazelwood, MO 63042-1755

Mailing AddressPo Box 776084Chicago, IL 60677-0019 · (314) 831-8600 · Fax (314) 831-0086

Phone(314) 831-8600

Fax(314) 839-5596

Sole ProprietorNo

Medical School CMSOtherGraduated 2003

Enumeration DateNovember 6, 2006

Last NPPES UpdateAugust 16, 20244 updates tracked since enumeration

NPPES CertifiedAugust 16, 2024

✔ NPI 1144399270 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MO · 2000164715

637 DUNN RD STE 102A, Hazelwood, MO 63042

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Other Identifiers 1

Medicaid2000164715MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Renitra Jackson Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4981708047

PECOS Enrollment IDI20070329000091

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

17 services17 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mercy Hospital St Louis

Acute Care Hospitals · Saint Louis, MO

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260020

Location615 New Ballas RoadSaint Louis, MO 63141 · St. Louis County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63042 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.32 typical visit price

range $55.65 – $169.38

Typical copayment $21.58 (range $13.91 – $42.34)

Most-billed visit code 99203

Established Patient

$98.37 typical visit price

range $17.76 – $137.92

Typical copayment $24.59 (range $4.44 – $34.48)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHAWN KHOSLA

Family Medicine