CAPITAL REGION MEDICAL CENTER (NPI# 1629031018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629031018 |
| Entity Type | Organization |
| Organization Name | CAPITAL REGION MEDICAL CENTER |
| Other Organization Name | CAPITAL REGION PHYSICIANS - PEDIATRIC ASSOCIATES |
| Practice Address |
1014 Madison St Jefferson City MO 65102-3458 |
| Mailing Address |
Po Box 1107 Jefferson City MO 65102-1107 |
| Practice Telephone | 5736325525 |
| Practice Fax Number | 5736325811 |
| Mailing Telephone | 5736325525 |
| Mailing Fax Number | 5736325811 |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2013-08-23 |
| Authorized Official Name | TOM LUEBBERING (VP OF FINANCE) |
| Authorized Official Telephone | 5736325100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
41910 | MO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 507515500 | 05 |
| Other Name | Type Code |
|---|---|
| Capital Region Physicians - Pediatric Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821228388 | Capital Region Medical Center | Internal Medicine | 999 Diamond Rdg, Suite 201, Jefferson City, MO 65109-6920 | 2009-07-19 |
| 1679701296 | Capital Region Medical Center | Family Medicine | 3308 W Edgewood, Suite B, Jefferson City, MO 65109 | 2009-06-23 |
| 1285810093 | Capital Region Medical Center | Family Medicine | 309 N. Main Street, Chamois, MO 65024 | 2008-01-11 |
| 1215057542 | Capital Region Medical Center | Physical Therapist | 1015 Moreau Dr, Jefferson City, MO 65101-3518 | 2007-03-30 |
| 1134188741 | Capital Region Medical Center | Clinic/Center | 3536 Kuhne Road, Owensville, MO 65066 | 2006-03-22 |
| 1215906433 | Capital Region Medical Center | Family Medicine | 2nd Street and Oak, Stover, MO 65078 | 2006-03-17 |
| 1710959598 | Capital Region Medical Center | Family Medicine | 180 Northstar St, Holts Summit, MO 65043-1123 | 2006-02-06 |
| 1730151143 | Capital Region Medical Center | Family Medicine | 704 Buchanan Hwy Sw, California, MO 65018 | 2006-02-02 |
| 1285606392 | Capital Region Medical Center | Nurse Practitioner | 103 Business Hwy 54 North, Eldon, MO 65026 | 2006-02-02 |
| 1487631776 | Capital Region Medical Center | Family Medicine | 901 Kidwell Dr, Versailles, MO 65084-1784 | 2005-12-28 |
| Street Address |
1014 MADISON ST |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65102-3458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386176840 | Jared James | Family Medicine | 1014 Madison St, Jefferson City, MO 65101-3458 | 2017-04-03 |
| 1821352857 | Carey Diana Vaughan | General Practice | 1014 Madison St, Jefferson City, MO 65101-3458 | 2012-06-25 |
| 1013279967 | Craig Alan Luetkemeyer | Family Medicine | 1014 Madison St, Jefferson City, MO 65101-3458 | 2012-06-15 |
| 1386906899 | Jamie Brianne Luetkemeyer | Family Medicine | 1014 Madison St, Jefferson City, MO 65101-3458 | 2012-06-11 |
| 1083912265 | Capital Region Medical Center | Obstetrics & Gynecology | 1014 Madison St, Suite B, Jefferson City, MO 65101-3458 | 2011-03-11 |
| 1831352202 | Nicole Josephine Albin | Family Medicine | 1014 Madison St, Jefferson City, MO 65101-3458 | 2008-07-07 |
| 1538117114 | Capital Region Medical Center | Nurse Practitioner | 1014 Madison St, Jefferson City, MO 65101-3458 | 2006-05-05 |
| 1790740942 | Dana Madsen Calcutt | Obstetrics & Gynecology | 1014 Madison St, Ob/gyn Associates, Jefferson City, MO 65101-3458 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649514050 | Capital Region Resident Clinic | General Practice | 220 Madison St., Jefferson City, MO 65102 | 2012-11-26 |
| 1659534386 | Cynthia L Hackathorn | Counselor | 1706 E Elm St, Jefferson City, MO 65102 | 2008-07-02 |
| 1821097783 | Scott Marrs | Family Medicine | 2511 W Edgewood, Ste D, Jefferson City, MO 65102 | 2005-07-21 |
| 1255487948 | Lynne Anne White | Occupational Therapist | 1125 Madison, Jefferson, MO 65102-1128 | 2007-01-26 |
| 1003872714 | Elbert Stinson Tillerson | Psychiatry & Neurology | 1125 Madison St., Jefferson City, MO 65102-1128 | 2006-04-21 |
| 1932429727 | Jonathan Andrew Heisinger | Health Educator | 1505 Southwest Blvd, Jefferson City, MO 65102-1128 | 2010-06-03 |
| 1164665766 | Colin Duggan | Psychologist | 1432 Southwest Blvd, Jefferson City, MO 65102-1128 | 2009-04-13 |
| 1013120583 | Christie L Stockton | Physical Therapist | 1125 Madison, Jefferson City, MO 65102-1128 | 2007-05-08 |
| 1265577852 | Bethany Naughton | Occupational Therapist | 1432 Southwest Blvd, Captial Region Home Health, Jefferson City, MO 65102-1128 | 2007-02-21 |
| 1639287915 | Heather Mcbee Johns | Social Worker | 1432 Southwest Blvd, Jefferson City, MO 65102-1128 | 2006-08-28 |
| Find all providers in zip 65102 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447857370 | Ssm Regional Health Services | Clinic/Center | 2505 Mission Dr, Jefferson City, MO 65109-9508 | 2020-10-05 |
| 1083105134 | Ssm Regional Health Services | Clinic/Center | 2505 Mission Dr Ste 130, Jefferson City, MO 65109 | 2018-05-24 |
| 1336555275 | Ssm Regional Health Services | Clinic/Center | 2505 Mission Dr, Suite 200, Jefferson City, MO 65109-9508 | 2014-07-10 |
| 1457763633 | Jefferson City Medical Group, PC | Clinic/Center | 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | 2014-05-22 |
| 1003096306 | Spine Midwest, Inc | Clinic/Center | 200 Saint Marys Medical Plz, Suite 301, Jefferson City, MO 65101-1604 | 2007-11-05 |
| 1336189398 | Jefferson City Medical Group, P.C. | Clinic/Center | 1241 W Stadium Blvd, First Floor, Suite 1100, Jefferson City, MO 65109 | 2006-06-07 |
| 1023081767 | Capital Region Medical Center | Clinic/Center | 1500 Southwest Blvd, Ste C, Jefferson City, MO 65109 | 2006-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023629458 | Palm Valley Health LLC | Clinic/Center | 1095 Nooning Tree Dr, Chesterfield, MO 63017-2468 | 2020-08-10 |
| 1477175594 | Confident American English, LLC | Clinic/Center | 1190 Jefferson St Ste 103a, Washington, MO 63090-4443 | 2020-05-12 |
| 1619513215 | Southeast Missouri Health Network | Clinic/Center | 835 W Murray Ln, Sikeston, MO 63801-4056 | 2019-11-19 |
| 1275014953 | Arch Pediatrics LLC | Clinic/Center | 3844 S Lindbergh Blvd Ste 216, Saint Louis, MO 63127-1369 | 2018-08-22 |
| 1174015515 | Washington University Physicians In Illinois, Inc | Clinic/Center | 4511 Forest Park Ave, Saint Louis, MO 63108-2138 | 2018-06-01 |
| 1164921300 | Texas County Memorial Hospital | Clinic/Center | 1333 S Sam Houston Blvd Ste A, Houston, MO 65483 | 2018-02-02 |
| 1053822650 | Edge Medical Services Inc. | Clinic/Center | 105 W 34th St Apt 2, Kansas City, MO 64111-1677 | 2017-10-23 |
| 1932618394 | United Physicians Group, LLC | Clinic/Center | 14825 N Outer 40 Rd Ste 365, Chesterfield, MO 63017-2152 | 2017-09-28 |
| 1073022000 | Fairview Heights Medical Group Sc | Clinic/Center | 670 Mason Ridge Center Dr Ste 300, Saint Louis, MO 63141-8573 | 2017-09-21 |
| 1013433762 | Elevating Care Clinic, LLC | Clinic/Center | 2340 E. Meyer Blvd, 208, Kansas City, MO 64132-1105 | 2017-08-15 |
| Find all providers with the same taxonomy | ||||
| City | JEFFERSON CITY |
| Zip Code | 65102 |
Please comment or provide details below to improve the information on CAPITAL REGION MEDICAL CENTER.
| 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.