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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
Street Address |
120 HOSPITAL DR SUITE 250 |
City | JEFFERSON CITY |
State | TN |
Zip Code | 37760-5279 |
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 |
Find all providers in the same location |
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 Code | 207V00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Obstetrics & Gynecology |
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. |
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 |
Find all providers in JEFFERSON CITY |
City | JEFFERSON CITY |
Zip Code | 37760 |
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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.