JEFFERSON MEDICAL GROUP


Address: 608 Missouri St, Waverly, MO 64096-8241
Phone: 6604932262

JEFFERSON MEDICAL GROUP (NPI# 1982034773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1982034773
Entity Type Organization
Organization Name JEFFERSON MEDICAL GROUP
Other Organization Name JEFFERSON MEDICAL GROUP WAVERLY CLINIC
Practice Address 608 Missouri St
Waverly
MO 64096-8241
Mailing Address 1502 N Jefferson St
Carrollton
MO 64633-1948
Practice Telephone 6604932262
Practice Fax Number 6605429880
Mailing Telephone 6605429998
Enumeration Date 2013-11-15
Last Update Date 2016-04-19
Authorized Official Name JEAN ANNE STEELE (OFFICE MANAGER)
Authorized Official Telephone 6605429998
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MO 50899330 05

Other Provider/Organization Names

Other Name Type Code
Jefferson Medical Group Waverly Clinic Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1104432806 Jefferson Medical Group Family Medicine 807 E Broadway St, Brunswick, MO 65236-1468 2020-09-17
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
1215030713 Jefferson Medical Group Clinic/Center 1502 N Jefferson St, Carrollton, MO 64633-1948 2006-09-07

Office Location

Street Address 608 MISSOURI ST
City WAVERLY
State MO
Zip Code 64096-8241

Providers in the same location

NPI Name Taxonomy Address Enumeration
1679555114 Patrick J Lowry Psychiatry & Neurology 608 Missouri St, Waverly, MO 64096-8241 2005-11-18
1073086955 Ambria Michelle Wimsatt Social Worker 608 Missouri St, Waverly, MO 64096-8241 2019-01-03
1982179446 Marc David Archer Nurse Practitioner 608 Missouri St, Waverly, MO 64096-8241 2018-10-10
1669843793 Cynthia Diane Stock Nurse Practitioner 608 Missouri St, Waverly, MO 64096 2015-10-15
1780957290 Jennifer Ann Patterson Registered Nurse 608 Missouri St, Waverly, MO 64096 2012-02-14
1881702454 Deborah G. Ashinhurst Nurse Practitioner 608 Missouri St, Waverly, MO 64096-8241 2006-08-25
1285699579 Gene A Mcfadden Family Medicine 608 Missouri St, Waverly, MO 64096-8241 2006-04-19

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1003295460 Kyra J Tracy Dental Hygienist 608 S Missouri St., Waverly, MO 64096 2015-05-19
1346205796 Dorothy L Dighton Nurse Practitioner Missouri St & Hwy 24, Waverly, MO 64096 2006-04-19
1174960769 Health Care Coalition of Lafayette County Clinic/Center 608 Missouri Street, Waverly, MO 64096-8421 2013-05-23
1134157191 Waverly 1 Inc Skilled Nursing Facility 100 West Thomas Drive, Waverly, MO 64096-9143 2006-06-29

Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1053547760 King Family Medical Pllc Clinic/Center 215b Holly Ln, Waverly, TN 37185-3387 2009-06-09
1770196453 Dickson Medical Associates, PC Clinic/Center 215b Holly Ln, Waverly, TN 37185-3387 2020-08-24
1245707108 Community Action Committee of Pike County Clinic/Center 715 W Emmitt Ave, Waverly, OH 45690-1015 2018-10-30
1700163045 Sean Stiltner, D.o.,llc Clinic/Center 715 W Emmitt Ave, Waverly, OH 45690-1015 2011-11-15
1760659171 Community Action Committee of Pike County Clinic/Center 227 Valleyview Dr, Family Health Center - Waverly, Waverly, OH 45690 2008-05-14
1386826766 Waverly Medical Practice,inc. Clinic/Center 207 St Anns Ln, Waverly, OH 45690-1040 2007-11-28

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1306313051 Country Care Family Clinic, LLC Clinic/Center 3 E Cleveland Ave, Ellsinore, MO 63937 2018-10-31
1285118950 Vera Whole Health, Wa PC Clinic/Center 8350 N. Church Road, Kansas City, MO 64158 2018-09-19
1003324542 Quad/med, LLC Clinic/Center 2015 Ne Jefferson Street, Grain Valley, MO 64029 2018-01-18
1093267601 Careatc-saint Peter Clinic/Center 4601 Executive Centre Pkwy, Saint Peters, MO 63376-1683 2016-10-30
1407303480 Kerns Family Health Care LLC Clinic/Center 1335 Vilage Dr B, St. Joseph, MO 64506-2457 2016-09-07
1316491020 Wecare Tlc - Wwt Mo Family Health Center Clinic/Center 58 Weldon Pkwy, Bldg 58, Maryland Heights, MO 63043-3237 2016-08-10
1255703500 Community Hospital Association Clinic/Center 101 South Washington Street, Oregon, MO 64473 2015-10-27
1023485752 Dennis E. Robinson D.o. Clinic/Center 487 Pomme De Terre Dr., Marshfield, MO 65706 2015-08-28
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Competitor

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City WAVERLY
Zip Code 64096

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Dataset Information

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.

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