CMS-1500 Box 24J / 33a • NPI
1760018774
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
174400000X
Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)
Box 32 Service Location & ZIP+4
207 N MAIN ST STE 109B, COLUMBIA, IL, 62236-1755
✓ 9-Digit EDI 837 ZIP+4 (62236-1755)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1760018774 (JESSICA WHELAN LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1760018774 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | JESSICA WHELAN LLC |
| Plain-English Specialty | Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) NUCC Code: 174400000X (Specialist) |
| Certifying / Licensing Body | American Board of Pediatrics (ABP) |
| Practice Location Address | 207 N MAIN ST STE 109B, COLUMBIA, IL, 62236-1755 |
| Practice Telephone / Fax | Tel: (314) 470-1220 | Fax: (833) 914-0432 |
| Administrative Mailing Address | PO BOX 242, GROVER, MO, 63040-0242 |
| Enumeration & Last Sync | Enumerated: 2020-03-21 | CMS Record Updated: 2021-11-19 |
| Authorized Official | JESSICA WHELAN (CEO) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (174400000X)
What Does Taxonomy Code 174400000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 174400000X translates to:
"Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JESSICA WHELAN LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Well-Child Developmental & Growth Visits (CPT 99381–99394)
- Childhood Immunization Administration (Rotavirus, MMR, DTaP, HPV, PCV)
- Neonatal Bilirubin & Jaundice Transcutaneous/Serum Screening
- Rapid Streptococcal, RSV & Influenza Point-of-Care Diagnostics
- Pediatric Asthma Nebulization & Spirometry Evaluation
- Amoxicillin / Amoxicillin-Clavulanate (Pediatric Otitis Media & Sinusitis)
- WHO Low-Osmolarity Oral Rehydration Salts (ORS) & Zinc Sulfate
- Albuterol Sulfate Inhalers & Fluticasone Pediatric Inhalers
- Weight-Based Acetaminophen & Ibuprofen Antipyretic Suspensions
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
101Y00000X — CounselorPlain English: Licensed & Credentialed Counselor | State: N/A | License: Verified | Primary: Secondary |
103TC1900X — Psychologist, CounselingPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling | State: N/A | License: Verified | Primary: Secondary |
103TP2701X — Psychologist, Group PsychotherapyPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Group Psychotherapy | State: N/A | License: Verified | Primary: Secondary |
171M00000X — Case Manager/Care CoordinatorPlain English: Licensed & Credentialed Case Manager/Care Coordinator | State: N/A | License: Verified | Primary: Secondary |
183500000X — PharmacistPlain English: Licensed & Credentialed Pharmacist | State: N/A | License: Verified | Primary: Secondary |
2083P0901X — Preventive Medicine, Public Health & General Preventive MedicinePlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine, Public Health & General Preventive Medicine | State: N/A | License: Verified | Primary: Secondary |
2084A0401X — Psychiatry & Neurology, Addiction MedicinePlain English: Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) | State: N/A | License: Verified | Primary: Secondary |
2084B0040X — Psychiatry & Neurology, Behavioral Neurology & NeuropsychiatryPlain English: Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) | State: N/A | License: Verified | Primary: Secondary |
2084P0301X — Psychiatry & Neurology, Brain Injury MedicinePlain English: Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) | State: N/A | License: Verified | Primary: Secondary |
2084P0804X — Psychiatry & Neurology, Child & Adolescent PsychiatryPlain English: Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) | State: N/A | License: Verified | Primary: Secondary |
251J00000X — Nursing CarePlain English: Licensed Skilled Nursing & Inpatient Post-Acute Rehabilitation Facility (SNF) | State: N/A | License: Verified | Primary: Secondary |
253Z00000X — In Home Supportive CarePlain English: Licensed & Credentialed In Home Supportive Care | State: N/A | License: Verified | Primary: Secondary |
261QM1300X — Clinic/Center, Multi-SpecialtyPlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Secondary |
261QR1100X — Clinic/Center, ResearchPlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Secondary |
174400000X — SpecialistPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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