JACQUELINE ANN BODE (APN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1245572213
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JACQUELINE ANN BODE (APN)
3165 McKelvey Rd Ste 205
Bridgeton, MO 630442550
Phone: (314) 282-3224
Type: Location
6698 Keaton Corporate Pkwy
O Fallon, MO 633688724
Phone: (636) 614-1638
Type: Location
15421 Clayton Rd
Ballwin, MO 630113163
Phone: (636) 552-4772
Type: Location
12860 TROXLER AVE
HIGHLAND, IL 622492898
Phone: (618) 651-2810
Type: Mailing
177 JESSICA DR
SAINT JACOB, IL 622811247
Phone: (618) 444-5491
Fax: (618) 551-3944
Type: Mailing
205 W PARK AVE STE 103
CHAMPAIGN, IL 618207888
Phone: (217) 284-6236
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $87.
Total Amount is formed as General ($87) + Research ($0) + Ownership ($0) = $87.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Lilly USA, LLC ($41).
Total Amount
$87
General + Research + Ownership
Payments
5
Total payment records
General Amount
$87
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $41 |
| Novo Nordisk Inc | $31 |
| GlaxoSmithKline, LLC. | $15 |
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: 2014-06-25
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 |
|---|---|---|---|---|
| I20140625000877 | I | Nurse Practitioner | IL | 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 63044)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Family Practice | IL | |
| G A S T R O E N T E R O L O G Y | TX | |
| Internal Medicine | IL | |
| General Surgery | IL | |
| - | IL | |
| General Surgery | IL | |
| Family Practice | IL | |
| - | IL | |
| - | IL |
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