JEFFERSON CITY MEDICAL GROUP-P C (NPI# 1235533498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235533498 |
| Entity Type | Organization |
| Organization Name | JEFFERSON CITY MEDICAL GROUP-P C |
| Other Organization Name | MISSOURI VALLEY PHYSICIANS A DIVISION OF JCMG |
| Practice Address |
2303 S Highway 65 Ste A Marshall MO 65340-3735 |
| Mailing Address |
Po Box 104240 Jefferson City MO 65110-4240 |
| Practice Telephone | 6608863364 |
| Practice Fax Number | 6608866044 |
| Mailing Telephone | 5736355264 |
| Mailing Fax Number | 5735565757 |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2018-12-26 |
| Authorized Official Name | JEFFREY LEE PATRICK (PRESIDENT) |
| Authorized Official Telephone | 5736355264 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1235533498 | 05 |
| Other Name | Type Code |
|---|---|
| Missouri Valley Physicians A Division of JCMG | Doing Business As Name - Organization |
| Street Address |
2303 S HIGHWAY 65 STE A |
| City | MARSHALL |
| State | MO |
| Zip Code | 65340-3735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356801328 | Justin Scot Cortez | Nurse Practitioner | 2303 S Highway 65 Ste A, Marshall, MO 65340-3735 | 2019-03-25 |
| 1316435225 | Tracy Jean Guthrie | Nurse Practitioner | 2303 S Highway 65 Ste A, Marshall, MO 65340 | 2018-04-25 |
| 1437668746 | Jefferson City Medical Group, PC | Clinic/Center | 2303 S Highway 65 Ste A, Marshall, MO 65340-3735 | 2017-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791847 | Gerald D Robertson | Chiropractor | 1566 S Odell Ave, Marshall, MO 65340 | 2019-07-15 |
| 1659860765 | William L Pearman | Nurse Practitioner | Marshall Emergency Physicians, 2305 South Highway 65, Marshall, MO 65340 | 2018-05-03 |
| 1992204978 | Susan Elizabeth Lichtenberg | Speech-Language Pathologist | 860 W. Vest St., Marshall, MO 65340 | 2018-02-06 |
| 1568974616 | Falin Kay Larsen | Family Medicine | 2303 Us-65, Marshal, MO 65340 | 2017-10-30 |
| 1881132587 | Dana Zinn | Nurse Practitioner | 1547 Commerce Dr, Marshall, MO 65340 | 2017-02-02 |
| 1760877179 | Lifetime Dental Associates | Dentist | 2301 S. 65 Hwy, Suite 1, Marshall, MO 65340 | 2015-04-02 |
| 1780078949 | Glenda Cervantes | Interpreter | 1324 S Ellswort Ave, Marshall, MO 65340 | 2015-03-26 |
| 1174922173 | Michelle Stockman | Licensed Practical Nurse | 1004 S. Lincoln Ave, Marshall, MO 65340 | 2014-08-15 |
| 1730527722 | Lynn C Evans | Pharmacist | 941 S. Cherokee, Suite 1, Marshall, MO 65340 | 2013-06-12 |
| 1740589753 | Bethany Anne Harris | Social Worker | 1126 E. Hwy Ww, Marshall, MO 65340 | 2011-03-17 |
| Find all providers in zip 65340 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760950737 | Hospital & Medical Foundation of Paris, Inc. | Family Medicine | 1602 Il Hwy 1, Marshall, IL 62441 | 2018-11-08 |
| 1336525666 | Idriss Ibrahim | Family Medicine | 309 E College Dr, Marshall, MN 56258-2379 | 2015-08-10 |
| 1417362039 | Melissa Kay Gates | Family Medicine | 1174 W Michigan Ave Ste A, Marshall, MI 49068-1625 | 2014-06-23 |
| 1114362902 | Charity U Eko | Family Medicine | 815 S Washington Ave Ste 303, Marshall, TX 75670-5358 | 2013-05-07 |
| 1033457429 | Richard Raynor | Family Medicine | 2105 E Watermill Rd, Marshall, MO 65340-4684 | 2013-01-21 |
| 1528351178 | Lori Anne Lynner | Family Medicine | 3160 Us Hwy 59, Marshall, MN 56258 | 2011-05-16 |
| 1669619441 | Mark D Richardson Md PC | Family Medicine | 215 E Mansion St Ste 1e, Marshall, MI 49068-1167 | 2009-01-15 |
| 1134307663 | Philip Rutherford Glotfelty IIi | Family Medicine | 635 N Linden St, Marshall, MI 49068-1054 | 2008-02-06 |
| 1104011295 | Mid-missouri Family Health, LLC | Family Medicine | 78 S. Jefferson, Marshall, MO 65340 | 2007-09-11 |
| 1790983609 | Jamie Lynn Longhurst | Family Medicine | 215 E Mansion St Ste 2a, Marshall, MI 49068 | 2007-07-03 |
| Find all providers in MARSHALL | ||||
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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.