FAMILY MEDICINE OF JEFFERSON CITY, LLC (NPI# 1043319957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043319957 |
| Entity Type | Organization |
| Organization Name | FAMILY MEDICINE OF JEFFERSON CITY, LLC |
| Practice Address |
1616 Southridge Dr Suite #203 Jefferson City MO 65109-5677 |
| Practice Telephone | 5736597300 |
| Practice Fax Number | 5736360555 |
| Mailing Telephone | 5736597300 |
| Mailing Fax Number | 5736360555 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DANIEL P LAVERY (OWNER/PRESIDENT) |
| Authorized Official Telephone | 5736597300 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | R9J28 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
1616 SOUTHRIDGE DR SUITE #203 |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109-5677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043315385 | John D Spears | Orthopaedic Surgery | 1616 Southridge Dr, Ste 202, Jefferson City, MO 65109-5677 | 2006-09-13 |
| 1588979900 | Capital Region Medical Center | Clinic/Center | 1616 Southridge Dr, Suite 203, Jefferson City, MO 65109-5677 | 2010-08-10 |
| 1265686125 | Missouri Spine Institute, LLC | Orthopaedic Surgery | 1616 Southridge Dr, Ste 202, Jefferson City, MO 65109-5677 | 2008-11-05 |
| 1649431420 | Jason Thomas | Registered Nurse | 1616 Southridge Dr, Ste 202, Jefferson City, MO 65109-5677 | 2008-06-24 |
| 1700093937 | Turnbaugh Surgical Associates, Inc | Durable Medical Equipment & Medical Supplies | 1616 Southridge Dr, Suite 202, Jefferson City, MO 65109-5677 | 2007-05-17 |
| 1083719975 | Daniel P Lavery | Family Medicine | 1616 Southridge Dr, Suite #203, Jefferson City, MO 65109-5677 | 2006-09-14 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215343769 | Jeffrey Lynn Teeter | Family Medicine | 3121 Emerald Ln Ste 800, Jefferson City, MO 65109-6843 | 2014-07-05 |
| 1770925794 | Amanda M Vickers | Family Medicine | 3527 W Truman Blvd Ste 100, Jefferson City, MO 65109-5902 | 2013-07-18 |
| 1679701296 | Capital Region Medical Center | Family Medicine | 3308 W Edgewood, Suite B, Jefferson City, MO 65109 | 2009-06-23 |
| 1972742807 | Greggory M Kuhlmann | Family Medicine | 3308 W Edgewood Dr Ste A, Jefferson City, MO 65109-6891 | 2009-02-17 |
| 1780867341 | Health Enhancements, P.C. | Family Medicine | 1739 Elm Court Plaza, Suite 106, Jefferson City, MO 65101 | 2007-12-06 |
| 1558551358 | Michael Eugene Sands | Family Medicine | 1500 Southwest Blvd Ste D, Jefferson City, MO 65109-2472 | 2007-07-27 |
| 1396886065 | Ssm Regional Health Services | Family Medicine | 2511 W Edgewood Dr Ste G, Jefferson City, MO 65109-5869 | 2007-02-08 |
| 1780724922 | Capital Family Care | Family Medicine | 1500 Southwest Blvd Ste B, Jefferson City, MO 65109-2472 | 2007-02-07 |
| 1528116910 | Primary Care Medicine PC | Family Medicine | 2709 Industrial Dr Ste A, Jefferson City, MO 65109-0769 | 2007-01-08 |
| 1285714691 | Neal Gerard Lapointe | Family Medicine | 420 E High St, Jefferson City, MO 65101-3215 | 2006-10-17 |
| Find all providers in JEFFERSON CITY | ||||
| 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.