DR. JACK WILLIAM JENNINGS (MD) – Diagnostic Radiology Physician, NPI 1164552774

DR. JACK WILLIAM JENNINGS (MD) is a healthcare provider. based in Saint louis, Missouri. specializing in DIAGNOSTIC RADIOLOGY. They hold the professional credentials MD. They hold a License No. 2007012290 (MO). The NPI Number for DR. JACK WILLIAM JENNINGS (MD) is 1164552774

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. JACK WILLIAM JENNINGS (MD)
NPI
1164552774
Phone
(314) 362-7200
Address
660 S EUCLID AVE
Enumeration Date
6 March 2007
Last Update Date
17 April 2025

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE
Secondary Phone
3142862500
Graduation Year
2002 (24 years ago)
PAC ID
1850482704
Group Practice PAC ID
9830008770
Professional Enrollment ID
I20070807000101
Address ID
MO631290002SA5225XPLZX400

Contacts

FHIR Endpoint
https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

1,218 DIAGNOSTIC RADIOLOGY in MO

Provider Addresses for DR. JACK WILLIAM JENNINGS (MD)

  • 660 S EUCLID AVE

    CB 8131

    SAINT LOUIS, MO 631101010

    Phone: (314) 362-7200

    Fax: (314) 747-4189

    Type: Mailing

  • PO BOX 7412011

    CHICAGO, IL 606742011

    Phone: (314) 362-7200

    Fax: (314) 747-4189

    Type: Mailing

  • 510 S KINGSHIGHWAY BLVD

    DEPT RADIOLOGY

    SAINT LOUIS, MO 631101016

    Phone: (314) 362-7200

    Fax: (314) 747-4189

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 55 Open Payments records for all available years, with a total value of $39,981.

Total Amount is formed as General ($39,981) + Research ($0) + Ownership ($0) = $39,981.

Last reported payment date: 2024-12-04 • Largest payer in this snapshot: Bard Peripheral Vascular, Inc. ($11,731).

Total Amount

$39,981

General + Research + Ownership

Payments

55

Total payment records

General Amount

$39,981

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-04

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2007-08-07

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070807000101IDiagnostic RadiologyMOTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
73030X-ray of shoulder, minimum of 2 views198182$0
99152Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes140123$0
73502X-ray of hip, 2-3 views131129$0
73562X-ray of knee, 3 views122109$0
73564X-ray of knee, 4 or more views10787$0
View full utilization report →

Insurance plans in this area (ZIP 63110)

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Provider's Procedures

DR. JACK WILLIAM JENNINGS (MD) performs procedures in DIAGNOSTIC RADIOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYMO73110X-ray of wrist, minimum of 3 views2317
DIAGNOSTIC RADIOLOGYMO73562X-ray of knee, 3 views6651
DIAGNOSTIC RADIOLOGYMO73630X-ray of foot, minimum of 3 views9886

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9830008770View full group profile

Reviews

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Frequently asked questions

Can I cross-check DR. JACK WILLIAM JENNINGS (MD) using NPI 1164552774?
NPI 1164552774 belongs to DR. JACK WILLIAM JENNINGS (MD); compare other details if you need extra assurance.
Is DR. JACK WILLIAM JENNINGS (MD) still an active registrant?
DR. JACK WILLIAM JENNINGS (MD) carries an active NPI according to the public dataset.
What kind of doctor is DR. JACK WILLIAM JENNINGS (MD)?
DR. JACK WILLIAM JENNINGS (MD) is associated with Diagnostic Radiology Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with DR. JACK WILLIAM JENNINGS (MD)?
Directory geography for DR. JACK WILLIAM JENNINGS (MD) centers on Saint Louis, Missouri.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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