JEFFERSON CITY OBSTETRICS & GYNECOLOGY INC (NPI# 1235311796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235311796 |
| Entity Type | Organization |
| Organization Name | JEFFERSON CITY OBSTETRICS & GYNECOLOGY INC |
| Practice Address |
2712 Plaza Dr Jefferson City MO 65109-1147 |
| Practice Telephone | 5738935500 |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2010-04-06 |
| Authorized Official Name | KWEI LEE SU (ADMINISTRATOR) |
| Authorized Official Telephone | 5738935500 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 119368 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
2712 PLAZA DR |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109-1147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871594218 | Jennifer M Su | Obstetrics & Gynecology | 2712 Plaza Dr, Jefferson City, MO 65109-1147 | 2005-08-09 |
| 1689666174 | Philo S Su | Obstetrics & Gynecology | 2712 Plaza Dr, Jefferson City, MO 65109-1147 | 2005-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518449321 | Kara D Roderick | Physical Therapist | 1115 Fairgrounds Road, Jefferson City, MO 65109 | 2018-08-29 |
| 1851871214 | Integrative Medicine, LLC | Internal Medicine | 999 Diamond Rdg Ste 201, Jefferson City, MO 65109 | 2018-08-15 |
| 1972020394 | Rehab Care Group East, LLC | Clinic/Center | Primrose Retirement Community Jefferson City, 1214 Freedom Boulevard, Jefferson City, MO 65109 | 2017-08-25 |
| 1124558986 | Nicholas Rehagen | Specialist/Technologist | 304 Timber Creek Rd, Jefferson City, MO 65109 | 2017-06-14 |
| 1982004214 | Kara Elizabeth Wilbers | Occupational Therapist | 1105 Fairgrounds Rd, Jefferson City, MO 65109 | 2014-08-22 |
| 1942510334 | Loftin Eyecare, LLC | Optometrist | 724 West Stadium Boulevard, # 029 Walmart Vision Center, Jefferson City, MO 65109 | 2010-10-19 |
| 1306077250 | Paula Hancock Johnson | Social Worker | 1303 Edgewood Dr Ste 5, Jefferson City, MO 65109 | 2009-07-27 |
| 1679701296 | Capital Region Medical Center | Family Medicine | 3308 W Edgewood, Suite B, Jefferson City, MO 65109 | 2009-06-23 |
| 1972730141 | Nancy S Stork | Counselor | 204 Metro, Suite B, Jefferson City, MO 65109 | 2009-06-16 |
| 1356522916 | Walk Easy LLC | Durable Medical Equipment & Medical Supplies | 4810 Rainbow Dr., Jefferson City, MO 65109 | 2007-11-23 |
| Find all providers in zip 65109 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801976261 | Angela J Breckenridge | Obstetrics & Gynecology | 1511 Christy Dr, Jefferson City, MO 65101-2854 | 2006-10-17 |
| 1669584041 | Womens Clinic of Jefferson City PC | Obstetrics & Gynecology | 200 St Marys Medical Plaza, Suite 102, Jefferson City, MO 65101 | 2006-08-31 |
| 1871594218 | Jennifer M Su | Obstetrics & Gynecology | 2712 Plaza Dr, Jefferson City, MO 65109-1147 | 2005-08-09 |
| 1912900085 | Elizabeth A Blanchard | Obstetrics & Gynecology | 1125 Madison St, Jefferson City, MO 65101-5227 | 2005-05-23 |
| 1083912265 | Capital Region Medical Center | Obstetrics & Gynecology | 1014 Madison St, Suite B, Jefferson City, MO 65101-3458 | 2011-03-11 |
| 1275866204 | Jefferson City Medical Group, P.C. | Obstetrics & Gynecology | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2009-09-09 |
| 1659506749 | Claypool Obstetrics and Gynecology LLC | Obstetrics & Gynecology | 1111 Madison St, Jefferson City, MO 65101-2753 | 2009-05-19 |
| 1356509871 | Jodi A Berendzen | Obstetrics & Gynecology | 1241 W Stadium Blvd, Suite 102, Jefferson City, MO 65109-6023 | 2008-05-30 |
| 1265639603 | Amanda Taube Rodemann | Obstetrics & Gynecology | 1241 W Stadium Blvd, Suite 102, Jefferson City, MO 65109-6023 | 2007-06-29 |
| 1518048735 | Serese Yvonne Smith-haxton | Obstetrics & Gynecology | 1125 Madison St, Jefferson City, MO 65101-5227 | 2006-10-17 |
| Find all providers in JEFFERSON CITY | ||||
| City | JEFFERSON CITY |
| Zip Code | 65109 |
Please comment or provide details below to improve the information on JEFFERSON CITY OBSTETRICS & GYNECOLOGY INC.
| 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.