CLINTON LEE HARRIS (NPI# 1417940321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417940321 |
| Entity Type | Individual |
| Full Name | CLINTON LEE HARRIS |
| Credential | MD |
| Practice Address |
1241 W Stadium Blvd Jefferson City MO 65109-6023 |
| Mailing Address |
Po Box 104240 Jefferson City MO 65110-4240 |
| Practice Telephone | 5735561706 |
| Practice Fax Number | 5735565728 |
| Mailing Telephone | 5736355264 |
| Mailing Fax Number | 5735565757 |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2019-09-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 2014015594 | MO | Allopathic & Osteopathic Physicians |
| N | 207L00000X | Anesthesiology | 35473 | IA | Allopathic & Osteopathic Physicians |
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
2014015594 | MO | Allopathic & Osteopathic Physicians |
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
35473 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0462077 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699927376 | Clinton Eric Harris | Emergency Medicine | 125-1 Greentree Dr, Dover, DE 19904 | 2008-10-14 |
| 1942415765 | Clinton Harris | Social Worker | 919 E 2nd St, Sanford, FL 32771-2101 | 2007-05-14 |
| Street Address |
1241 W STADIUM BLVD |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109-6023 |
| 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 | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427043124 | Dianna M. Adkison | Anesthesiology | 1445 Christy Dr, Jefferson City, MO 65101-2853 | 2005-09-19 |
| 1164830337 | Jefferson City Medical Group, PC | Anesthesiology | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2014-07-31 |
| 1326091059 | Mid-missouri Anesthesia Consultants PC | Anesthesiology | 1445 Christy Dr, Jefferson City, MO 65101-2853 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679088900 | Midwest Pain Management Clinic LLC | Anesthesiology | 1011 Old Olive Way Apt 403, Creve Coeur, MO 63141-5959 | 2017-12-08 |
| 1235579749 | Nicki D Rippeteau | Anesthesiology | 4606 E 184th St, Belton, MO 64012-8323 | 2013-06-28 |
| 1518217322 | Advanced Anesthesia and Pain Management, LLC | Anesthesiology | 12805 Topping Woods Estate Drive, St. Louis, MO 63131 | 2012-09-19 |
| 1265794911 | Regeneration Orthopedics, LLC | Anesthesiology | 6 Mcbride & Son Center Dr., Ste 204, Chesterfield, MO 63005 | 2012-06-08 |
| 1265727572 | Rebecca A Sanders | Anesthesiology | 1002 Mcintosh Cir Ste 6, Joplin, MO 64804-3600 | 2011-06-15 |
| 1457655748 | Melrich Inc | Anesthesiology | 625 Cannonbury Dr, Saint Louis, MO 63119-5312 | 2010-12-31 |
| 1700016250 | Oluseyi Fadegbola Ogundimu | Anesthesiology | 661 Fisher Dr, Sullivan, MO 63080-1533 | 2009-07-17 |
| 1467640235 | Shavonne L. Danner, M.d., L.L.C. | Anesthesiology | 2525 Glenn Henden Dr, Liberty, MO 64068 | 2007-10-05 |
| 1225171648 | Benjamin A Lampert | Anesthesiology | 1730 E Portland St, Springfield, MO 65804-1311 | 2007-02-15 |
| 1972651578 | Advanced Pain Specialists, Inc. | Anesthesiology | 7510 Big Bend Blvd, Saint Louis, MO 63119-2104 | 2007-01-08 |
| Find all providers with the same taxonomy | ||||
| City | JEFFERSON CITY |
| Zip Code | 65109 |
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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.