DR. CLARENCE WILLIAM JAGGARD JR. (NPI# 1932602125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932602125 |
| Entity Type | Individual |
| Full Name | DR. CLARENCE WILLIAM JAGGARD JR. |
| Credential | MD |
| Practice Address |
Ozark Valley Medical Clinic 5571 N. 21st St. Ozark MO 65721 |
| Mailing Address |
5571 North 21st St. Ozark MO 65721 |
| Practice Telephone | 4173175330 |
| Practice Fax Number | 4177633370 |
| Mailing Telephone | 4173175330 |
| Mailing Fax Number | 4177633370 |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2017039470 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | ASSISTANT PHYSICIAN LICENSE | 2017039470 | 01 |
| VA | PHARMACY LICENSE | 0202204519 | 01 |
| VA | DRIVERS LICENSE NUMBER | T61723021 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Lift Up Springfield 2005 E. Kearney St. Suite A, Springfield, MO 65803 | 0000000000 |
| Street Address |
OZARK VALLEY MEDICAL CLINIC 5571 N. 21ST ST. |
| City | OZARK |
| State | MO |
| Zip Code | 65721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063054880 | Ramya Sravani Pakala | Family Medicine | 5571 N. 21st St., Ozark, MO 65721 | 2019-10-14 |
| 1871073346 | Regional Services | Nurse Practitioner | 1350 W Bluff Dr, Ozark, MO 65721 | 2018-08-15 |
| 1053826750 | Veronica Keller | Speech-Language Pathologist | 3608 N. Highway Nn, Ozark, MO 65721 | 2017-12-05 |
| 1124546304 | Kara Nicole Peterson | Speech-Language Pathologist | 302 N 4th Ave., Ozark, MO 65721 | 2017-09-07 |
| 1912391368 | Mobile X-ray Services, LLC | Clinic/Center | 3050 N. 20th Street, Ozark, MO 65721 | 2015-03-24 |
| 1073787289 | Melissa Milan | Counselor | 332 South 3rd Street, Ozark, MO 65721 | 2008-04-17 |
| 1306038948 | Preferred Hospice of Missouri Southwest LLC | Hospice Care, Community Based | 1567 West Diane, Suite B, Ozark, MO 65721 | 2007-08-17 |
| 1508073040 | Retirement At Century Pines Inc. | Assisted Living Facility | 709 E. Mccracken, Ozark, MO 65721 | 2007-05-16 |
| 1184844482 | Ozark Medical Imaging Center | Radiology | 1500 W State Hwy J, Ozark, MO 65721 | 2007-04-27 |
| 1770702102 | Ozark Medical Imaging LLC | Radiology | 1500 W. State Hwy J, Ozark, MO 65721 | 2007-04-24 |
| Find all providers in zip 65721 | ||||
| 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 |
|---|---|---|---|---|
| 1063054880 | Ramya Sravani Pakala | Family Medicine | 5571 N. 21st St., Ozark, MO 65721 | 2019-10-14 |
| 1912418369 | Evelyn Guillotti Partain | Family Medicine | 5571 N 21st St, Ozark, MO 65721-7488 | 2017-10-12 |
| 1821363524 | Dale Medical Center | Family Medicine | 320 White Ave, Ozark, AL 36360-0908 | 2012-03-13 |
| 1720226020 | Richard S Hammock,md Dba Dale Medical Center | Family Medicine | 218 Hospital Ave Ste A, Ozark, AL 36360-2072 | 2009-01-26 |
| 1790874931 | Holly J. Benedict | Family Medicine | 1106 W Jackson St, Ozark, MO 65721-9164 | 2006-10-12 |
| 1942392949 | Lester E Cox Medical Centers | Family Medicine | 506 E South St, Evans Plaza, Ozark, MO 65721-8571 | 2006-09-28 |
| 1538275342 | Dale Medical Center | Family Medicine | 218 Hospital Ave Ste B, Ozark, AL 36360-2072 | 2006-08-22 |
| 1346278793 | Taylor D Caffey | Family Medicine | 370 James Street, Suite 101, Ozark, AL 36360 | 2006-06-28 |
| 1215977129 | Connie A Chandler | Family Medicine | 145 Katherine Ave, Ozark, AL 36360-1976 | 2006-06-08 |
| 1174584171 | Robert J Kreutzmann | Family Medicine | 633 S Union Ave, Ozark, AL 36360-1836 | 2006-03-29 |
| Find all providers in OZARK | ||||
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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.