JEFFERSON CITY MEDICAL GROUP, P.C. (NPI# 1336189398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336189398 |
| Entity Type | Organization |
| Organization Name | JEFFERSON CITY MEDICAL GROUP, P.C. |
| Practice Address |
1241 W Stadium Blvd First Floor, Suite 1100 Jefferson City MO 65109 |
| Mailing Address |
Po Box 104240 Jefferson City MO 65110-4240 |
| Practice Telephone | 5735565747 |
| Practice Fax Number | 5736369756 |
| Mailing Telephone | 5735565747 |
| Mailing Fax Number | 5736369756 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2018-06-08 |
| Authorized Official Name | MELISSA ASTIN (VICE PRESIDENT OF OPERATIONS) |
| Authorized Official Telephone | 5735567774 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MEDICARE RAILROAD | CD6061 | 01 |
| MO | MEDICARE RAILROAD | CD6060 | 01 |
| MO | MEDICARE RAILROAD | CD6058 | 01 |
| MO | MEDICARE RAILROAD | CD6059 | 01 |
| MO | MEDICARE RAILROAD | CC7852 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700084316 | Jefferson City Medical Group, P.C. | Surgery | 2511 W Edgewood Dr Ste A&h, Jefferson City, MO 65109-5869 | 2007-07-05 |
| 1194880708 | Jefferson City Medical Group, P.C. | Durable Medical Equipment & Medical Supplies | 1225 W. Stadium Blvd, Jefferson City, MO 65109 | 2006-12-26 |
| 1083661615 | Jefferson City Medical Group, P.C. | Family Medicine | 1306 E Main St, Linn, MO 65051-2503 | 2006-05-28 |
| 1811292105 | Jefferson City Medical Group, P.C. | Clinical Medical Laboratory | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2011-01-18 |
| 1275866204 | Jefferson City Medical Group, P.C. | Obstetrics & Gynecology | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2009-09-09 |
| 1972668903 | Jefferson City Medical Group, P.C. | Dermatology | 1241 W Stadium Blvd, Suite 1407, Jefferson City, MO 65109-6023 | 2006-12-27 |
| 1851457881 | Jefferson City Medical Group, P.C. | Orthopaedic Surgery | 1241 W Stadium Blvd, Lower Level, Suite 400a, Jefferson City, MO 65109-6023 | 2006-12-27 |
| 1396801353 | Jefferson City Medical Group, P.C. | Physical Medicine & Rehabilitation | 1225 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2006-12-27 |
| 1467518423 | Jefferson City Medical Group, P.C. | Obstetrics & Gynecology | 1241 W Stadium Blvd, Suite 1140, Jefferson City, MO 65109-6023 | 2006-12-27 |
| 1477618486 | Jefferson City Medical Group, P.C. | Clinic/Center | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2006-12-27 |
| Street Address |
1241 W STADIUM BLVD FIRST FLOOR, SUITE 1100 |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801899851 | Robert E Ferris | Specialist | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2005-05-23 |
| 1013542109 | Ashlee Kathleen Parkes | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2020-03-09 |
| 1508498601 | Samantha Michelle Findley | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2020-02-06 |
| 1891335360 | Carson Mikaela Borgmeyer | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2020-01-13 |
| 1215570585 | Cortny Osie-ann Vandergrift | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2019-10-19 |
| 1912569906 | Sarah Loveland Jennett | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2019-07-01 |
| 1699339754 | Sumnima Neupane | Nurse Anesthetist, Certified Registered | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2019-04-24 |
| 1720545999 | Angela Kay Watkins | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2019-02-25 |
| 1811471667 | Morgan Elizabeth Grace Su | Nurse Practitioner | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2018-09-18 |
| 1780105007 | Jennifer Lynn Adelman | Registered Nurse | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2017-06-28 |
| Find all providers in the same location | ||||
| 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 | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629031018 | Capital Region Medical Center | Clinic/Center | 1014 Madison St, Jefferson City, MO 65102-3458 | 2006-04-08 |
| 1447857370 | Ssm Regional Health Services | Clinic/Center | 2505 Mission Dr, Jefferson City, MO 65109-9508 | 2020-10-05 |
| 1083105134 | Ssm Regional Health Services | Clinic/Center | 2505 Mission Dr Ste 130, Jefferson City, MO 65109 | 2018-05-24 |
| 1336555275 | Ssm Regional Health Services | Clinic/Center | 2505 Mission Dr, Suite 200, Jefferson City, MO 65109-9508 | 2014-07-10 |
| 1457763633 | Jefferson City Medical Group, PC | Clinic/Center | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2014-05-22 |
| 1003096306 | Spine Midwest, Inc | Clinic/Center | 200 Saint Marys Medical Plz, Suite 301, Jefferson City, MO 65101-1604 | 2007-11-05 |
| 1023081767 | Capital Region Medical Center | Clinic/Center | 1500 Southwest Blvd, Ste C, Jefferson City, MO 65109 | 2006-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023629458 | Palm Valley Health LLC | Clinic/Center | 1095 Nooning Tree Dr, Chesterfield, MO 63017-2468 | 2020-08-10 |
| 1477175594 | Confident American English, LLC | Clinic/Center | 1190 Jefferson St Ste 103a, Washington, MO 63090-4443 | 2020-05-12 |
| 1619513215 | Southeast Missouri Health Network | Clinic/Center | 835 W Murray Ln, Sikeston, MO 63801-4056 | 2019-11-19 |
| 1275014953 | Arch Pediatrics LLC | Clinic/Center | 3844 S Lindbergh Blvd Ste 216, Saint Louis, MO 63127-1369 | 2018-08-22 |
| 1174015515 | Washington University Physicians In Illinois, Inc | Clinic/Center | 4511 Forest Park Ave, Saint Louis, MO 63108-2138 | 2018-06-01 |
| 1164921300 | Texas County Memorial Hospital | Clinic/Center | 1333 S Sam Houston Blvd Ste A, Houston, MO 65483 | 2018-02-02 |
| 1053822650 | Edge Medical Services Inc. | Clinic/Center | 105 W 34th St Apt 2, Kansas City, MO 64111-1677 | 2017-10-23 |
| 1932618394 | United Physicians Group, LLC | Clinic/Center | 14825 N Outer 40 Rd Ste 365, Chesterfield, MO 63017-2152 | 2017-09-28 |
| 1073022000 | Fairview Heights Medical Group Sc | Clinic/Center | 670 Mason Ridge Center Dr Ste 300, Saint Louis, MO 63141-8573 | 2017-09-21 |
| 1013433762 | Elevating Care Clinic, LLC | Clinic/Center | 2340 E. Meyer Blvd, 208, Kansas City, MO 64132-1105 | 2017-08-15 |
| Find all providers with the same taxonomy | ||||
| City | JEFFERSON CITY |
| Zip Code | 65109 |
Please comment or provide details below to improve the information on JEFFERSON CITY MEDICAL GROUP, P.C..
| 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.