JEFFERSON CITY MEDICAL GROUP, P.C. (NPI# 1619033644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619033644 |
| Entity Type | Organization |
| Organization Name | JEFFERSON CITY MEDICAL GROUP, P.C. |
| Other Organization Name | JEFFERSON CITY EYE CONSULTANTS |
| Practice Address |
1241 W Stadium Blvd Suite 1020 Jefferson City MO 65109-6023 |
| Mailing Address |
Po Box 104240 Jefferson City MO 65110-4240 |
| Practice Telephone | 5736355264 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2018-12-26 |
| Authorized Official Name | DR. JEFFREY LEE PATRICK (PRESIDENT) |
| Authorized Official Telephone | 5736355264 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 508227303 | 05 | |
| MO | MEDICARE RAILROAD | CP9089 | 01 |
| MO | MEDICARE RAILROAD | CC7852 | 01 |
| Other Name | Type Code |
|---|---|
| Jefferson City Eye Consultants | Doing Business As Name - Organization |
| 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 SUITE 1020 |
| 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 | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| 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 Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962842476 | Philip Joseph Wilson IIi | Ophthalmology | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2013-06-28 |
| 1548471618 | Bradley Edward Talley | Ophthalmology | 1705 Christy Dr, Ste. 101, Jefferson City, MO 65101-5195 | 2007-05-24 |
| 1821057449 | Andrew L. Weiss | Ophthalmology | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2006-03-22 |
| 1053385096 | Capital Region Medical Center | Ophthalmology | 1432 Southwest Blvd, Jefferson City, MO 65109 | 2006-02-15 |
| 1568436509 | Larry K Stauffer | Ophthalmology | 1432 Southwest Blvd, Jefferson City, MO 65109 | 2006-02-15 |
| 1225013121 | Robert P. Wankum | Ophthalmology | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2005-12-13 |
| 1114902327 | Philip J. Wilson II | Ophthalmology | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2005-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780299578 | Heart of America Eye Care Pa | Ophthalmology | 1147 E North Ave, Belton, MO 64012-5105 | 2020-09-09 |
| 1962020644 | Matthew Theodore Hirabayashi | Ophthalmology | University Hospital One Hospital Dr Dc052.00, Columbia, MO 65212-0001 | 2020-07-09 |
| 1508484288 | Travis Parker | Ophthalmology | University Hospital One Hospital Drive Dc 052.00, Columbia, MO 65212-0001 | 2020-07-09 |
| 1003466897 | Mcelhinney Eye Care, Pa | Ophthalmology | 1004 Carondelet Dr Ste 405, Kansas City, MO 64114-4801 | 2019-09-13 |
| 1952965493 | Eric Jiaming Zhang | Ophthalmology | University Hospital One Hospital Dr Dc.052.00, Columbia, MO 65212-0001 | 2019-04-30 |
| 1790265759 | Washington University | Ophthalmology | 4901 Forest Park Ave # 8221, Saint Louis, MO 63108-1495 | 2018-08-20 |
| 1023597127 | Eye Care Pa | Ophthalmology | 1018 W Foxwood Drive, Raymore, MO 64083 | 2018-08-09 |
| 1255716221 | Summit Eye Center, LLC | Ophthalmology | 1621 Nw Blue Parkway, Lees Summit, MO 64086 | 2015-07-20 |
| 1184038986 | Grace L Paley | Ophthalmology | 621 S New Ballas Rd Ste 5006b, Saint Louis, MO 63141-8270 | 2014-06-19 |
| 1871907378 | Daniel Joseph Watson | Ophthalmology | 900 N Highway 67 St, Florissant, MO 63031 | 2014-06-12 |
| 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.