ELBERT STINSON TILLERSON (NPI# 1003872714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003872714 |
| Entity Type | Individual |
| Full Name | ELBERT STINSON TILLERSON |
| Credential | MD |
| Practice Address |
1125 Madison St. Jefferson City MO 65102-1128 |
| Practice Telephone | 5736357651 |
| Practice Fax Number | 5736594515 |
| Mailing Telephone | 5736357651 |
| Mailing Fax Number | 5736594515 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2013-01-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
2011041481 | MO | Allopathic & Osteopathic Physicians |
| Y | 208M00000X | Hospitalist | 2011041481 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 1 | 23919 | 01 |
| GA | LICENSE | 054133 | 01 |
| MO | 1003872714 | 05 |
| Street Address |
1125 MADISON ST. |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65102-1128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801054622 | Capital Region Medical Center | Surgery | 1125 Madison St., Jefferson City, MO 65102-1236 | 2008-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649514050 | Capital Region Resident Clinic | General Practice | 220 Madison St., Jefferson City, MO 65102 | 2012-11-26 |
| 1659534386 | Cynthia L Hackathorn | Counselor | 1706 E Elm St, Jefferson City, MO 65102 | 2008-07-02 |
| 1821097783 | Scott Marrs | Family Medicine | 2511 W Edgewood, Ste D, Jefferson City, MO 65102 | 2005-07-21 |
| 1255487948 | Lynne Anne White | Occupational Therapist | 1125 Madison, Jefferson, MO 65102-1128 | 2007-01-26 |
| 1932429727 | Jonathan Andrew Heisinger | Health Educator | 1505 Southwest Blvd, Jefferson City, MO 65102-1128 | 2010-06-03 |
| 1164665766 | Colin Duggan | Psychologist | 1432 Southwest Blvd, Jefferson City, MO 65102-1128 | 2009-04-13 |
| 1013120583 | Christie L Stockton | Physical Therapist | 1125 Madison, Jefferson City, MO 65102-1128 | 2007-05-08 |
| 1265577852 | Bethany Naughton | Occupational Therapist | 1432 Southwest Blvd, Captial Region Home Health, Jefferson City, MO 65102-1128 | 2007-02-21 |
| 1639287915 | Heather Mcbee Johns | Social Worker | 1432 Southwest Blvd, Jefferson City, MO 65102-1128 | 2006-08-28 |
| 1629031018 | Capital Region Medical Center | Clinic/Center | 1014 Madison St, Jefferson City, MO 65102-3458 | 2006-04-08 |
| Find all providers in zip 65102 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033135496 | Ssm Regional Health Services | Hospitalist | 2505 Mission Dr, Jefferson City, MO 65109-9508 | 2006-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679987481 | Ziad Sayedahmad | Hospitalist | 3635 Vista Ave Fl 13, Saint Louis, MO 63110-2539 | 2014-06-19 |
| 1063708238 | Ramya Chinnasamy | Hospitalist | 621 S New Ballas Rd Ste 112a, Saint Louis, MO 63141-8252 | 2011-06-25 |
| 1720231483 | Holzum Healthcare LLC | Hospitalist | 2 Progress Point, Ste 101a, O Fallon, MO 63368-2208 | 2008-10-28 |
| 1164688552 | Landmark Hospital of Cape Girardeau, LLC | Hospitalist | 3255 Independence St, Cape Girardeau, MO 63701-4914 | 2008-08-05 |
| 1639235203 | Brian Craig Silverman | Hospitalist | 901 East 5th Street, St. John's Mercy Hospital, Washington, MO 63090 | 2006-12-28 |
| 1093826935 | Northland Hospitalsts LLC | Hospitalist | 3724 N Quincy Circle, Kansas City, MO 64119-0278 | 2006-08-31 |
| 1194779579 | Inpatient Consultants of Missouri Inc | Hospitalist | 12125 Woodcrest Executive Dr, Suite 220, Saint Louis, MO 63141-5001 | 2006-05-20 |
| 1699329086 | Stanley Wade Balch II | Hospitalist | 315 S Osteopathy Ave, Kirksville, MO 63501-6401 | 2019-07-24 |
| 1992362776 | Margaret Fonseca | Hospitalist | 224 S Woods Mill Rd Ste 580, Chesterfield, MO 63017-3513 | 2019-05-28 |
| 1033671243 | Sol Allan Enriquez | Hospitalist | 19600 E 39th St S, Independence, MO 64057-2301 | 2019-04-05 |
| Find all providers with the same taxonomy | ||||
| City | JEFFERSON CITY |
| Zip Code | 65102 |
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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.