CMMP SURGICAL CENTER LLC (NPI# 1528060704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528060704 |
| Entity Type | Organization |
| Organization Name | CMMP SURGICAL CENTER LLC |
| Practice Address |
1705 Christy Dr Ste 100 Jefferson City MO 65101-5195 |
| Practice Telephone | 5736357022 |
| Practice Fax Number | 5736595443 |
| Mailing Telephone | 5736357022 |
| Mailing Fax Number | 5736595443 |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | DR. CARL R DOERHOFF (MAJORITY PHYSICIAN OWNER) |
| Authorized Official Telephone | 5736595401 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
95-6 | MO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | BCBS OF MO PROV NUMBER | 37 | 01 |
| MO | UNITED HLTH CARE PROV NUM | 6800140 | 01 |
| MO | HEALTHLINK PROV NUMBER | 537147 | 01 |
| Street Address |
1705 CHRISTY DR STE 100 |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65101-5195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124491345 | Sierra Binkley | Physical Therapist | 1705 Christy Dr, Ste 200, Jefferson City, MO 65101-5195 | 2015-11-10 |
| 1255762852 | Capital Region Medical Center | Family Medicine | 1705 Christy Dr, Suite 201, Jefferson City, MO 65101-5195 | 2013-12-06 |
| 1063757003 | Jessica Lynn Clark | Physical Therapist | 1705 Christy Dr, Suite 200, Jefferson City, MO 65101-5195 | 2012-12-03 |
| 1073868808 | Central Missouri Diagnostic Services, LLC | Clinical Medical Laboratory | 1705 Christy Dr, Suite 105, Jefferson City, MO 65101-5195 | 2012-07-18 |
| 1780958173 | Capital Region Medical Center | Specialist | 1705 Christy Dr, Suite 215, Jefferson City, MO 65101-5195 | 2012-03-02 |
| 1750691143 | David Cranston | Physical Therapist | 1705 Christy Dr, Ste. 200, Jefferson City, MO 65101-5195 | 2010-10-19 |
| 1023346715 | Elizabeth A Farmer | Physical Therapist | 1705 Christy Dr, Suite 200, Jefferson City, MO 65101-5195 | 2009-11-18 |
| 1508094251 | Donnetta Lynn Wilkerson | Physical Therapist | 1705 Christy Dr, Suite 200, Jefferson City, MO 65101-5195 | 2009-07-01 |
| 1457594814 | Tamara V. Hopkins, M.d., L.L.C. | Internal Medicine | 1705 Christy Dr, Suite 201, Jefferson City, MO 65101-5195 | 2009-04-15 |
| 1346412863 | Physicians Optical Service Inc | Durable Medical Equipment & Medical Supplies | 1705 Christy Dr, Ste 103, Jefferson City, MO 65101-5195 | 2008-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619468527 | Lhcg Cxxxxiii, LLC | Home Health | 1125 Madison St Ste C, Jefferson City, MO 65101 | 2018-05-25 |
| 1396254629 | Lauren Mellon | Speech-Language Pathologist | 6124 Falcon Lane, Jefferson City, MO 65101 | 2017-09-29 |
| 1518375708 | Daven Nanda | Pharmacist | 2101 N Schotthill Woods Dr., Jefferson City, MO 65101 | 2014-07-31 |
| 1699183228 | Mark Nitz | Pharmacist | 2101 N Schotthill Dr, Jefferson City, MO 65101 | 2014-07-28 |
| 1386923472 | Lorinda Jo Leer | Occupational Therapist | 1403 Riverside Drive, Jefferson City, MO 65101 | 2011-08-08 |
| 1124334503 | Kimberly K Baumhoer | Hearing Instrument Specialist | 315 Ellis Blvd. Suite 202, Hearing Aid Consultants, Jefferson City, MO 65101 | 2010-08-24 |
| 1780867341 | Health Enhancements, P.C. | Family Medicine | 1739 Elm Court Plaza, Suite 106, Jefferson City, MO 65101 | 2007-12-06 |
| 1336364819 | Jerome Satorre | Occupational Therapist | 505 Ellis Blvd, Apt B20, Jefferson, MO 65101 | 2007-04-17 |
| 1326263450 | Bryan M. Pope, Dds Inc. | Dentist | 200 St. Mary's Medical Plaza, Suite 101, Jefferson City, MO 65101 | 2007-04-16 |
| 1104948769 | Kenneth Mark Skouby | Social Worker | 515a East Mccarty, Jefferson City, MO 65101 | 2007-04-04 |
| Find all providers in zip 65101 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023169380 | Jcmg Surgery Center, Inc. | Clinic/Center | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2007-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393130 | United Surgical Center, LLC | Clinic/Center | 638 Chamblee Ln, Creve Coeur, MO 63141-7323 | 2020-07-22 |
| 1801443320 | St. Luke's Surgery Center of Chesterfield, LLC | Clinic/Center | 111 St. Luke's Center Drive, Bldg B, Suite 500, Chesterfield, MO 63017-3509 | 2019-08-20 |
| 1255991238 | Lee Summit Asc Kc LLC | Clinic/Center | 2861 Ne Independence Avenue, Suite 101, Lee's Summitt, MO 64064 | 2019-06-20 |
| 1467925180 | Metro St Louis Surgery Center LLC | Clinic/Center | 1035 Bellevue Ave Ste 117, Saint Louis, MO 63117-1854 | 2019-01-04 |
| 1295207587 | Commons South Surgery Center, LLC | Clinic/Center | 12345 W Bend Dr Ste 201, Saint Louis, MO 63128-2254 | 2018-12-26 |
| 1922574391 | The Phoenix Oversight and Consulting, LLC. | Clinic/Center | 7746 Rannells Ave, Saint Louis, MO 63143-1823 | 2018-10-23 |
| 1700363611 | Apollo Ambulatory Surgery Center, LLC | Clinic/Center | 10012 Manchester Rd, Saint Louis, MO 63122-1826 | 2018-07-24 |
| 1336649565 | Advanced Surgical Care of St. Louis, LLC | Clinic/Center | 232 Mayfair Plaza Shopping Ctr, Florissant, MO 63033-8009 | 2018-02-14 |
| 1730698374 | Advanced Surgical Center of Sunset Hills LLC | Clinic/Center | 4594 S Lindbergh Blvd, Saint Louis, MO 63127 | 2017-09-27 |
| 1093224297 | United Physicians Group, LLC | Clinic/Center | 1100 Town and Country Commons Dr # 7805, Town and Country, MO 63017-8285 | 2017-09-20 |
| Find all providers with the same taxonomy | ||||
| City | JEFFERSON CITY |
| Zip Code | 65101 |
Please comment or provide details below to improve the information on CMMP SURGICAL CENTER LLC.
| 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.