ANTIONETTE JORDAN
NPI 1275249237
Nurse Practitioner in Saint Louis, MO

Q: What is Antionette Jordan's NPI number?

The NPI number for Antionette Jordan is 1275249237. It was assigned to this individual provider in the NPPES registry on January 24, 2023.

Q: What is Antionette Jordan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Antionette Jordan was last updated on August 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 January 24, 2023PECOS EnrolledAccepts Medicare Assignment

10004 KENNERLY RD STE 374B, SAINT LOUIS, MO 63128(314) 842-9669(314) 842-1017 Get Directions Write a Review

NPPES record last updated: August 6, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Antionette Jordan NPPES

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

ANTIONETTE JORDAN (NPI 1275249237) is an individual nurse practitioner in Saint Louis, Missouri, licensed in Missouri (2022047351) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital - St Louis, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1275249237

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameANTIONETTE JORDAN

Location Address10004 KENNERLY RD STE 374BSaint Louis, MO 63128-2178

Mailing AddressPo Box 802841Kansas City, MO 64180-2841 · (314) 842-9669 · Fax (314) 842-1017

Phone(314) 842-9669

Fax(314) 842-1017

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateJanuary 24, 2023

Last NPPES UpdateAugust 6, 2023

NPPES CertifiedAugust 6, 2023

✔ NPI 1275249237 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MO · 2022047351

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

10004 KENNERLY RD STE 374B, Saint Louis, MO 63128

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Other Identifiers 2

Other2022047351MO · License

Medicaid420120169MO

Accepted Insurance

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

Antionette Jordan 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 ID8628441623

PECOS Enrollment IDI20230222000310

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 5

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

51 services27 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

40 services24 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

25 services15 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

24 services15 patients

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

13 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Ssm Health St Mary's Hospital - St Louis

Acute Care Hospitals · Richmond Heights, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260091

Location6420 Clayton RdRichmond Heights, MO 63117 · St. Louis County

Emergency services Birthing friendly

Ssm Health Depaul Hospital St Louis

Acute Care Hospitals · Bridgeton, MO

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number260104

Location12303 Depaul DriveBridgeton, MO 63044 · St. Louis County

Emergency services Birthing friendly

Christian Hospital Northeast

Acute Care Hospitals · Saint Louis, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260180

Location11133 Dunn RoadSaint Louis, MO 63136 · St. Louis County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63128 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.

ALANTE M JONES FNP

Nurse Practitioner (Family)