JENNA MATTHEWS (NPI# 1689210924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689210924 |
Entity Type | Individual |
Full Name | JENNA MATTHEWS |
Other Name | JENNA CHARBONEAU |
Practice Address |
4601 Executive Centre Pkwy Ste 300 Saint Peters MO 63376-1685 |
Mailing Address |
532 Pevely Heights Dr Pevely MO 63070-2990 |
Practice Telephone | 6362445890 |
Mailing Telephone | 3149712958 |
Enumeration Date | 2019-11-21 |
Last Update Date | 2019-11-21 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
2019028561 | MO | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AMERICAN ACADEMY OF NURSE PRACTITIONERS | AG06190154 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427429174 | Jenna Matthews | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2015-10-07 |
1922369289 | Jenna Lynne Matthews | Developmental Therapist | 321 Fortune Blvd, Milford, MA 01757-1750 | 2012-06-04 |
1780872960 | Jenna Lynn Matthews | Dietitian, Registered | 2585 3rd Ave, Huntington, WV 25703-1642 | 2007-10-12 |
Street Address |
4601 EXECUTIVE CENTRE PKWY STE 300 |
City | SAINT PETERS |
State | MO |
Zip Code | 63376-1685 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457958837 | Ashish Javer | Family Medicine | 4601 Executive Centre Pkwy Ste 300, Saint Peters, MO 63376-1685 | 2020-10-08 |
1457972044 | Mo Biologics Inc | Family Medicine | 4601 Executive Centre Pkwy Ste 300, Saint Peters, MO 63376-1685 | 2020-05-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275047946 | Nicholas Christian Schultz | Dentist | 100 Piper Hill Dr Ste A, Saint Peters, MO 63376 | 2017-11-16 |
1982120093 | Carol Weber | Speech-Language Pathologist | 166 Boone Hills Dr., St Peters, MO 63376 | 2017-08-21 |
1619424744 | Forefront Dermatology, S.c. | Dermatology | 5700 Mexico Rd, Suite 14, Saint Peters, MO 63376 | 2016-09-07 |
1508310632 | Preferred Family Healthcare, Inc. | Counselor | 2120 Parkway Dr, Saint Peters, MO 63376 | 2016-08-05 |
1598130676 | Delta Center Personal Attendant Services | In Home Supportive Care | 3833 Mcclay, Suite 61, St. Peters, MO 63376 | 2015-12-01 |
1427420314 | Barbara Marlene Edelman | Counselor | 1286 Jungerman Rd. Suite G, St. Peters, MO 63376 | 2015-10-30 |
1255740247 | Claire Williams | Dentist | 340 Mid Rivers Mall Drive, Suite E, St. Peters, MO 63376 | 2014-08-05 |
1184042855 | Keith Wickenhauser | Internal Medicine | 201 Bjc Saint Peters Dr Ste 100, Saint Peters, MO 63376 | 2014-03-31 |
1821415233 | Abby Link | Physician Assistant | 107 Piper Parkway, #150, St. Peters, MO 63376 | 2014-03-24 |
1225452105 | Ashley Gagel | Physical Therapist | 7055 Mexico Rd Suite 1601, St. Peters, MO 63376 | 2014-02-12 |
Find all providers in zip 63376 |
Taxonomy Code | 207QA0505X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Adult Medicine |
Definition to come. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710948468 | Eileen O Lamb | Family Medicine | 2730 S Highway 94, Saint Peters, MO 63303-5677 | 2006-03-31 |
1508827395 | David A Peter | Family Medicine | 1600 Heritage Lndg, Ste 215, Saint Peters, MO 63303-8488 | 2006-03-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134728207 | Bryanna Scherer | Family Medicine | 961 Weatherstone Dr, Saint Charles, MO 63304-4520 | 2020-10-20 |
1396210852 | Catholic Charities of St. Louis | Family Medicine | 10120 Crest Rd., St. Joachim Catholic Church-attn: Rural Parish Clinic, Cadet, MO 63630 | 2018-10-10 |
1437686508 | Paul Anthony Williams Jr. | Family Medicine | 4431 Mcpherson Ave, Saint Louis, MO 63108-2505 | 2017-05-18 |
1548516685 | John Jung | Family Medicine | 3014 Blattner Dr, Cape Girardeau, MO 63703-6361 | 2012-07-26 |
1245485408 | Leslie Arroyo Robins | Family Medicine | 20 Legends Parkway, Suite 110, Eureka, MO 63025 | 2008-12-01 |
1245494665 | Jeffrey A Wool | Family Medicine | 1531 E 32nd St, Suite 1a, Joplin, MO 64804-2925 | 2008-07-15 |
1245407543 | Harry D Haas | Family Medicine | 16703 N Calico Rd, Versailles, MO 65084-6434 | 2008-05-15 |
1194902510 | Gary Hubert Campbell | Family Medicine | 21 Conway Springs Dr, Chesterfield, MO 63017-3411 | 2008-01-28 |
1568596336 | Mahrukh Khan | Family Medicine | 7491 Big Bend Blvd., St. Louis, MO 63119 | 2007-03-15 |
1669525275 | Stefan Scheidler | Family Medicine | 301 South Byp, Kennett, MO 63857-3252 | 2007-01-18 |
Find all providers with the same taxonomy |
City | SAINT PETERS |
Zip Code | 63376 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.