RENITRA JACKSON (FNP) – Family Nurse Practitioner, NPI 1144399270
Family Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
7,023 NURSE PRACTITIONER in MO
Provider Addresses for RENITRA JACKSON (FNP)
PO BOX 23340
SAINT LOUIS, MO 631563340
Phone: (314) 838-5702
Fax: (314) 839-5596
Type: Mailing
637 DUNN RD STE 102A
HAZELWOOD, MO 630421755
Phone: (314) 831-8600
Fax: (314) 839-5596
Type: Location
PO BOX 776084
CHICAGO, IL 606770019
Phone: (314) 831-8600
Fax: (314) 831-0086
Type: Mailing
Olive Boulevard, Creve Coeur, Saint Louis County, Missouri, 63132, United States
SAINT LOUIS, MO 631416291
Phone: (314) 851-1000
Fax: (314) 851-4445
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $241.
Total Amount is formed as General ($241) + Research ($0) + Ownership ($0) = $241.
Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Abbott Laboratories ($176).
Total Amount
$241
General + Research + Ownership
Payments
6
Total payment records
General Amount
$241
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $176 |
| Lilly USA, LLC | $36 |
| SANOFI-AVENTIS U.S. LLC | $30 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-03-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070329000091 | I | Nurse Practitioner | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63156)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| Internal Medicine | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| - | IL | |
| - | MO | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MO | |
| Physical Medicine And Rehabilitation | MO | |
| - | MO | |
| Nurse Practitioner | MO |
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