DR. NICHOLAS TANNER JESPERSON DO
NPI 1609660554
Family Medicine in Saint Louis, MO

Q: What is Nicholas Jesperson's NPI number?

The NPI number for Nicholas Jesperson is 1609660554. It was assigned to this individual provider in the NPPES registry on April 7, 2025.

Q: What is Nicholas Jesperson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since April 07, 2025PECOS Enrolled

12680 OLIVE BLVD STE 300, SAINT LOUIS, MO 63141(314) 251-8888(314) 251-8889 Get Directions Write a Review

NPPES record last updated: June 26, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 26, 2025, Apr 7, 2025 (2 updates tracked since 2025).

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About Dr. Nicholas Tanner Jesperson Do NPPES

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

DR. NICHOLAS TANNER JESPERSON DO (NPI 1609660554) is an individual family medicine provider in Saint Louis, Missouri, licensed in Missouri (2025025432) and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609660554

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. NICHOLAS TANNER JESPERSONCredential: DO

Location Address12680 OLIVE BLVD STE 300Saint Louis, MO 63141-6322

Mailing Address12680 Olive Blvd Ste 300Saint Louis, MO 63141-6322 · (314) 251-8888 · Fax (314) 251-8889

Phone(314) 251-8888

Fax(314) 251-8889

Sole ProprietorYes

Enumeration DateApril 7, 2025

Last NPPES UpdateJune 26, 20252 updates tracked since enumeration

NPPES CertifiedJune 26, 2025

✔ NPI 1609660554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MO · 2025025432

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

12680 OLIVE BLVD STE 300, Saint Louis, MO 63141

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicholas Tanner Jesperson Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63141 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 20

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

PRIYA SURESH KANNA MD

Family Medicine