SSM REGIONAL HEALTH SERVICES (NPI# 1396782587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396782587 |
| Entity Type | Organization |
| Organization Name | SSM REGIONAL HEALTH SERVICES |
| Other Organization Name | SSM HEALTH MEDICAL GROUP - PEDIATRICS |
| Practice Address |
3348 American Ave Jefferson City MO 65109-1079 |
| Mailing Address |
Po Box 1027 Jefferson City MO 65102-1027 |
| Practice Telephone | 5737617210 |
| Practice Fax Number | 5736348802 |
| Mailing Telephone | 5736813767 |
| Mailing Fax Number | 5737616947 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2020-09-15 |
| Authorized Official Name | GARRICK ELLIOTT MUELLER (CFO) |
| Authorized Official Telephone | 4052807582 |
| Is Organization Subpart | Y |
| Parent Organization Name | SSM REGIONAL HEALTH SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 501283501 | 05 |
| Other Name | Type Code |
|---|---|
| SSM Health Medical Group - Pediatrics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669856829 | Ssm Regional Health Services | Clinic/Center | 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 | 2015-07-16 |
| 1679961577 | Ssm Regional Health Services | Clinic/Center | 2505 Mission Dr Ste 130, Jefferson City, MO 65109-9508 | 2014-12-30 |
| 1306280185 | Ssm Regional Health Services | Clinic/Center | 301 E Price Ave, Suite A, Savannah, MO 64485-2427 | 2013-04-23 |
| 1396886065 | Ssm Regional Health Services | Family Medicine | 2511 W Edgewood Dr Ste G, Jefferson City, MO 65109-5869 | 2007-02-08 |
| 1427063072 | Ssm Regional Health Services | Pharmacy | 875 Hwy 5 South, Tipton, MO 65081-8253 | 2006-07-30 |
| 1518909373 | Ssm Regional Health Services | Family Medicine | 24 West 4th Street, Grant City, MO 64456-0043 | 2006-06-13 |
| 1588601777 | Ssm Regional Health Services | Clinic/Center | 875 State Route 5, Tipton, MO 65081-8441 | 2006-05-31 |
| 1053368159 | Ssm Regional Health Services | Clinic/Center | 2701 West Edgewood, Suite 101, Jefferson City, MO 65109 | 2006-05-27 |
| 1952357352 | Ssm Regional Health Services | Clinic/Center | 140 Northstar Dr, Holts Summit, MO 65043-1123 | 2006-05-26 |
| 1043266034 | Ssm Regional Health Services | Clinic/Center | 801 Kidwell Dr, Versailles, MO 65084-1783 | 2006-05-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | SSM REGIONAL HEALTH SERVICES | 10101 Woodfield Lane, St. Louis, MO 63132 |
| Street Address |
3348 AMERICAN AVE |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109-1079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487166401 | Melinda Jean Phillips | Nurse Practitioner | 3348 American Ave, Jefferson City, MO 65109-1079 | 2017-10-31 |
| 1417333253 | Olga Brea Pena | Pediatrics | 3348 American Ave, Jefferson City, MO 65109-1079 | 2015-08-04 |
| 1467835199 | Bethany Crawford | Pediatrics | 3348 American Ave, Jefferson City, MO 65109-1079 | 2015-06-30 |
| 1740565779 | Tara Lyn Kempker | Registered Nurse | 3348 American Ave, Jefferson City, MO 65109-1079 | 2011-10-21 |
| 1083649115 | George L Mcelroy | Pediatrics | 3348 American Ave, Jefferson City, MO 65109-1079 | 2006-07-11 |
| 1568495125 | Deborah L Palada | Nurse Practitioner | 3348 American Ave, Jefferson City, MO 65109-1079 | 2006-07-08 |
| 1093746653 | Brian Conley | Pediatrics | 3348 American Ave, Jefferson City, MO 65109-1079 | 2006-07-05 |
| 1912937798 | Mary Deeken | Pediatrics | 3348 American Ave, Jefferson City, MO 65109-1079 | 2006-07-04 |
| 1255361036 | Jennifer Krause | Pediatrics | 3348 American Ave, Jefferson City, MO 65109-1079 | 2006-07-04 |
| 1063440154 | William Busby | Pediatrics | 3348 American Ave, Jefferson City, MO 65109-1079 | 2006-06-29 |
| Find all providers in the same location | ||||
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366865263 | Align Chiropractic Clinic LLC | Clinic/Center | 1002 Diamond Rdg, Suite 200, Jefferson City, MO 65109-6896 | 2014-01-28 |
| 1487961173 | Mountain View Pediatrics and Internal Medicine | Clinic/Center | 657 E Broadway Blvd, Jefferson City, TN 37760-4948 | 2010-09-02 |
| 1588979900 | Capital Region Medical Center | Clinic/Center | 1616 Southridge Dr, Suite 203, Jefferson City, MO 65109-5677 | 2010-08-10 |
| 1770804734 | Capital Region Medical Center | Clinic/Center | 1125 Madison St, Jefferson City, MO 65101-5227 | 2010-06-14 |
| 1942528930 | Jefferson Pulmonary Group | Clinic/Center | 120 Hospital Dr Ste 220, Jefferson City, TN 37760-5286 | 2010-05-14 |
| 1740415025 | Jefferson Hearts Consultants | Clinic/Center | 120 Hospital Dr, Suite 250, Jefferson City, TN 37760-5287 | 2009-05-15 |
| 1962637231 | Baptist Primary & Senior Healthcare Clinic Jefferson City | Clinic/Center | 1413 Russell Ave, Jefferson City, TN 37760-2562 | 2009-05-15 |
| 1467597872 | Family Counseling Center of Missouri Inc | Clinic/Center | 204 Metro Dr, Suite B, Jefferson City, MO 65109-4408 | 2007-02-21 |
| 1679510861 | Ssm Regional Health Services | Clinic/Center | 200 Saint Marys Plz, Suite 201, Jefferson City, MO 65101-1604 | 2006-05-31 |
| 1649217837 | Ssm Regional Health Services | Clinic/Center | 2505 Mission Dr, Suite 310, Jefferson City, MO 65109-9508 | 2006-05-31 |
| Find all providers in JEFFERSON CITY | ||||
| City | JEFFERSON CITY |
| Zip Code | 65109 |
Please comment or provide details below to improve the information on SSM REGIONAL HEALTH SERVICES.
| 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.