JEFFERSON MEDICAL GROUP (NPI# 1619276367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619276367 |
| Entity Type | Organization |
| Organization Name | JEFFERSON MEDICAL GROUP |
| Practice Address |
1502 N Jefferson St Carrollton MO 64633-1948 |
| Practice Telephone | 6605429998 |
| Practice Fax Number | 6605429880 |
| Mailing Telephone | 6605429998 |
| Mailing Fax Number | 6605429880 |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2016-04-19 |
| Authorized Official Name | JEAN ANNE STEELE (CLINIC MANAGER) |
| Authorized Official Telephone | 6605429998 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 50899330 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104432806 | Jefferson Medical Group | Family Medicine | 807 E Broadway St, Brunswick, MO 65236-1468 | 2020-09-17 |
| 1982034773 | Jefferson Medical Group | Clinic/Center | 608 Missouri St, Waverly, MO 64096-8241 | 2013-11-15 |
| 1760772743 | Jefferson Medical Group | Clinic/Center | 221 Elm St, Hale, MO 64643-7113 | 2011-04-12 |
| 1467742452 | Jefferson Medical Group | Clinic/Center | 105 E 2nd St, Norborne, MO 64668-1301 | 2011-04-12 |
| 1215030713 | Jefferson Medical Group | Clinic/Center | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2006-09-07 |
| Street Address |
1502 N JEFFERSON ST |
| City | CARROLLTON |
| State | MO |
| Zip Code | 64633-1948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205831013 | Carroll County Memorial Hospital | Home Health | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2005-06-17 |
| 1003441122 | Ess of Carroll County LLC | Emergency Medicine | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2020-03-09 |
| 1649805763 | Hcc of Carroll County LLC | Internal Medicine | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2020-03-09 |
| 1477073328 | Erin Elizabeth Finkeldei | Nurse Practitioner | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2017-06-21 |
| 1700253812 | Jonna Hickcox Rechterman | Nurse Practitioner | 1502 N Jefferson St, Carrollton, MO 64633 | 2015-08-24 |
| 1841625233 | Tanya Waddle Land | Nurse Practitioner | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2013-09-05 |
| 1154678415 | Meritas Health Corporation | Internal Medicine | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2012-08-06 |
| 1720342629 | Andrew Douglas Horine | Family Medicine | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2012-06-26 |
| 1366752768 | Carroll County Medical Clinic | Family Medicine | 1502 N Jefferson St, St Suite A B, Carrollton, MO 64633-1948 | 2010-10-19 |
| 1952557399 | Carroll County Hospital Phtysicians | General Acute Care Hospital | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2008-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295140572 | B-pharm, Inc | Pharmacy | 1003 Highway 65 North, Suite B, Carrollton, MO 64633 | 2014-06-25 |
| 1023252541 | Pamela Lynn Ralls | Family Medicine | 1502 N.jefferson Street, Ccmh Medical Plaza, Carrollton, MO 64633 | 2009-04-28 |
| 1578733648 | Sloan Eyecare Center L.l.c | Optometrist | 1405 N Jefferson, Carroll County Jefferson Medical Pavillion, Carrollton, MO 64633 | 2008-03-05 |
| 1679616742 | Arlene Capistrano Germann | Residential Treatment Facility, Emotionally Disturbed Children | 1102 Lakeview Ct, Carrollton, MO 64633 | 2007-02-15 |
| 1932110483 | Tori D Waggoner | Pharmacist | 1003 Hwy 65 North, Carrollton, MO 64633 | 2006-08-10 |
| 1376553511 | Gay Lynn Korff | Pharmacist | 1003 Hwy. 65, Carrollton, MO 64633 | 2006-08-09 |
| 1790730182 | Missouri Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1003 N Us Highway 65, Carrollton, MO 64633 | 2006-05-23 |
| 1790097764 | Jodi Dawn Ahnefeld | Pharmacist | 1003 Hwy 65 North, Carrollton, MO 64633 | 2010-07-07 |
| 1770618274 | James Mitchell Germann | Day Training/Habilitation Specialist | 1102 Lakeview Ct, Carrollton, MO 64633 | 2007-02-23 |
| 1205038783 | Carroll County Health Department | Public Health or Welfare | 5 N Ely St, Carrollton, MO 64633-1309 | 2007-06-05 |
| Find all providers in zip 64633 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205753 | Pickens County Primary Care PC | Clinic/Center | 99 Commerce Avenue, Carrollton, AL 35447 | 2020-11-06 |
| 1255970513 | Orrville Hospital Foundation | Clinic/Center | 1020 Trump Rd Nw Ste 2/4, Carrollton, OH 44615-8422 | 2020-01-03 |
| 1205309044 | Boa Vida Hospital of Aberdeen, Ms LLC | Clinic/Center | 184 William E Hill Drive Ste C, Carrollton, AL 35447 | 2019-01-04 |
| 1689079642 | Jersey Community Hospital | Clinic/Center | 523 S Main St, Carrollton, IL 62016-1256 | 2014-11-03 |
| 1891102323 | Pickens County Medical Center, Inc | Clinic/Center | 289 William E Hill Dr Ste C, Carrollton, AL 35447-3247 | 2014-07-16 |
| 1982891057 | Ccmh Corporation | Clinic/Center | 309 11th St, Carrollton, KY 41008-1435 | 2007-10-02 |
| 1275694168 | Carroll County Medical Advisors Lp | Clinic/Center | 309 11th Street, Carrollton, KY 41008 | 2006-12-13 |
| 1164507604 | Thomas H. Boyd Memorial Hospital | Clinic/Center | 800 School St, Carrollton, IL 62016-1436 | 2006-10-25 |
| 1215030713 | Jefferson Medical Group | Clinic/Center | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2006-09-07 |
| 1740209667 | Tenet Healthsystem Hospitals Dallas, Inc. | Clinic/Center | 4343 N Josey Ln, Carrollton, TX 75010-4603 | 2006-07-19 |
| Find all providers in CARROLLTON | ||||
| City | CARROLLTON |
| Zip Code | 64633 |
Please comment or provide details below to improve the information on JEFFERSON MEDICAL GROUP.
| 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.