ST MARYS OBGYN LLC


Address: 120 Hospital Dr, Suite 250, Jefferson City, TN 37760-5279
Phone: 8654712644

ST MARYS OBGYN LLC (NPI# 1912963422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912963422
Entity Type Organization
Organization Name ST MARYS OBGYN LLC
Practice Address 120 Hospital Dr
Suite 250
Jefferson City
TN 37760-5279
Mailing Address 900 East Oak Hill Avenue
Knoxville
TN 37917-4556
Practice Telephone 8654712644
Practice Fax Number 8654712649
Mailing Telephone 8655458000
Mailing Fax Number 8655453105
Enumeration Date 2006-04-24
Last Update Date 2009-08-07
Authorized Official Name MRS. DEBRA K LONDON (CHIEF EXECUTIVE OFFICER)
Authorized Official Telephone 8655457558
Is Organization Subpart Y
Parent Organization Name ST. MARY'S HEALTH SYSTEM, INC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207V00000X Obstetrics & Gynecology Allopathic & Osteopathic Physicians

Office Location

Street Address 120 HOSPITAL DR
SUITE 250
City JEFFERSON CITY
State TN
Zip Code 37760-5279

Providers in the same location

NPI Name Taxonomy Address Enumeration
1730646084 Angela Brooke Burkhalter Physician Assistant 120 Hospital Dr, Jefferson City, TN 37760-5287 2019-02-22
1013374503 Aaron C. Harris Physician Assistant 120 Hospital Dr, Suite 130, Jefferson City, TN 37760-5287 2016-01-28
1982076766 Melissa A Cameron Nurse Practitioner 120 Hospital Dr, Suite 130, Jefferson City, TN 37760-5287 2015-10-20
1700267929 Tabetha Mcgill Health Educator 120 Hospital Dr, Suite 130, Jefferson City, TN 37760-5287 2015-06-12
1699107672 Kevin Dwayne Hyatt Student in an Organized Health Care Education/Training Program 120 Hospital Dr, Suite 230, Jefferson City, TN 37760-5287 2013-08-01
1538412333 Eva Huntsman Nurse Practitioner 120 Hospital Dr, Suite 130, Jefferson City, TN 37760-5287 2012-10-18
1073862124 Sheri Agatha Nsamenang Student in an Organized Health Care Education/Training Program 120 Hospital Dr, Suite 230, Jefferson City, TN 37760-5287 2012-09-05
1558633370 Vicki Lynn Merritt Case Manager/Care Coordinator 120 Hospital Dr, Suite 230, Jefferson City, TN 37760-5287 2012-02-09
1730461666 Jacqueline S Zgiet Nurse Practitioner 120 Hospital Dr, Suite 130, Jefferson City, TN 37760-5287 2011-09-16
1912289471 Janet Colleen Hall Registered Nurse 120 Hospital Dr, Suite 230, Jefferson City, TN 37760-5287 2011-09-12
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699235929 Emmley L Cole Nurse Practitioner 277 E W Broadway Blvd, Jefferson, TN 37760 2019-03-22
1275044877 Cindy Anderson Nurse Practitioner 277 E Broadway Blvd, Jefferson City, TN 37760 2017-10-23
1801259940 Mcfarland Group, Inc. Durable Medical Equipment & Medical Supplies 665 E Broadway Blvd, Jefferson City, TN 37760 2016-04-04
1124422266 Penny Williams-cordeiro Nurse Practitioner 1901 Brookside Drive, Suite 105, Kingsport, TN 37760 2014-10-17
1215363841 Lindsey Ann Clyde Physician Assistant 120 Hospital Dr Ste 130, Jefferson City, TN 37760 2013-09-14
1679849814 Allison Renee Farris Surgery 120 Hospital Dr Ste G20, Jefferson City, TN 37760 2012-03-31
1245562891 Steven Jarvis Monroe Dentist 156 W. Broadway Blvd., Jefferson City, TN 37760 2010-02-08
1952560625 Summit Medical Group,pllc Internal Medicine 380 W Broadway Blvd, Jefferson City, TN 37760 2008-06-06
1780756189 Steven J Monroe Dds PC Dentist 156 W Broadway Blvd, Jefferson City, TN 37760 2006-11-14
1720188600 Dennis U Spjut Psychologist 732 E Jefferson St, Dennis Spjut Phd, Jefferson City, TN 37760 2006-09-22
Find all providers in zip 37760

Taxonomy Information

Taxonomy Code 207V00000X
Grouping Allopathic & Osteopathic Physicians
Classification Obstetrics & Gynecology

Taxonomy Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
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 Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1801976261 Angela J Breckenridge Obstetrics & Gynecology 1511 Christy Dr, Jefferson City, MO 65101-2854 2006-10-17
1669584041 Womens Clinic of Jefferson City PC Obstetrics & Gynecology 200 St Marys Medical Plaza, Suite 102, Jefferson City, MO 65101 2006-08-31
1871594218 Jennifer M Su Obstetrics & Gynecology 2712 Plaza Dr, Jefferson City, MO 65109-1147 2005-08-09
1912900085 Elizabeth A Blanchard Obstetrics & Gynecology 1125 Madison St, Jefferson City, MO 65101-5227 2005-05-23
1083912265 Capital Region Medical Center Obstetrics & Gynecology 1014 Madison St, Suite B, Jefferson City, MO 65101-3458 2011-03-11
1275866204 Jefferson City Medical Group, P.C. Obstetrics & Gynecology 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 2009-09-09
1659506749 Claypool Obstetrics and Gynecology LLC Obstetrics & Gynecology 1111 Madison St, Jefferson City, MO 65101-2753 2009-05-19
1356509871 Jodi A Berendzen Obstetrics & Gynecology 1241 W Stadium Blvd, Suite 102, Jefferson City, MO 65109-6023 2008-05-30
1235311796 Jefferson City Obstetrics & Gynecology Inc Obstetrics & Gynecology 2712 Plaza Dr, Jefferson City, MO 65109-1147 2007-11-27
1265639603 Amanda Taube Rodemann Obstetrics & Gynecology 1241 W Stadium Blvd, Suite 102, Jefferson City, MO 65109-6023 2007-06-29
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Competitor

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City JEFFERSON CITY
Zip Code 37760

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Dataset Information

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.

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