JEFFERSON MEDICAL GROUP (NPI# 1215030713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215030713 |
| 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 | 2006-09-07 |
| Last Update Date | 2016-04-19 |
| Authorized Official Name | MS. JEAN STEELE (CLINIC MANAGER) |
| Authorized Official Telephone | 6605429998 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| 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 |
| 1619276367 | Jefferson Medical Group | Clinic/Center | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2011-03-21 |
| 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 |
| 1619276367 | Jefferson Medical Group | Clinic/Center | 1502 N Jefferson St, Carrollton, MO 64633-1948 | 2011-03-21 |
| 1366752768 | Carroll County Medical Clinic | Family Medicine | 1502 N Jefferson St, St Suite A B, Carrollton, MO 64633-1948 | 2010-10-19 |
| 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 | 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 |
|---|---|---|---|---|
| 1417428772 | Bowdon-mt Zion Primary Health Center Inc. | Family Medicine | 4248 Mount Zion Rd, Carrollton, GA 30117-7602 | 2018-12-16 |
| 1841761533 | Sewell Family Medicine and Urgent Care, P.C. | Family Medicine | 928 S Park St Ste H, Carrollton, GA 30117-4501 | 2018-12-06 |
| 1922515048 | Carrollton Primary Care Medicine Pllc | Family Medicine | 1809 Golden Trail Ct Ste 240, Carrollton, TX 75010-4667 | 2018-01-10 |
| 1598276610 | Healthpros Medical Center, Pllc | Family Medicine | 2548 Tarpley Rd, Carrollton, TX 75006-2328 | 2017-10-16 |
| 1912417858 | Akenjem Ebong Mba | Family Medicine | 1902 Country Club Dr Ste 160, Carrollton, TX 75006-5823 | 2017-10-05 |
| 1265783815 | Nirav A Patel | Family Medicine | 2761 E Trinity Mills Rd Ste 100, Carrollton, TX 75006-3507 | 2012-09-23 |
| 1275880163 | Lezlie Miller | Family Medicine | 3032 E Hebron Pkwy Ste 101, Carrollton, TX 75010-4465 | 2012-08-09 |
| 1265796049 | Carl R Fry | Family Medicine | 1020 Trump Rd Nw Ste 4, Carrollton, OH 44615-8423 | 2012-06-27 |
| 1679869317 | Harveer Singh Parmar | Family Medicine | 1212 N Josey Ln Ste 110, Carrollton, TX 75006-6103 | 2011-06-21 |
| 1215160197 | Jose P Parcon M D S C | Family Medicine | 727 9th St, Carrollton, IL 62016-1427 | 2009-08-26 |
| Find all providers in CARROLLTON | ||||
| City | CARROLLTON |
| Zip Code | 64633 |
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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.