MR. JEREMY RAY TJARKS (NPI# 1992063697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992063697 |
| Entity Type | Individual |
| Full Name | MR. JEREMY RAY TJARKS |
| Credential | MS, LAT, ATC |
| Practice Address |
2135 S Fremont Ave Springfield MO 65804-2239 |
| Mailing Address |
2349 W Nottingham St Springfield MO 65810-2298 |
| Practice Telephone | 4178207990 |
| Mailing Telephone | 4177613210 |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2012-05-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246Z00000X | Specialist/Technologist, Other | 2009024749 | MO | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NATIONAL ATHLETIC TRAINERS ASSOCIATION BOARD OF CERTIFICATION NU | 020602071 | 01 | |
| MO | MISSOURI STATE BOARD OF LICENSER | 2009024749 | 01 |
| Street Address |
2135 S FREMONT AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-2239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578528840 | Alicia Marie Inmon | Specialist/Technologist | 2135 S Fremont Ave, Springfield, MO 65804-2239 | 2006-04-19 |
| 1699219717 | Ashleigh Kate Gray | Occupational Therapist | 2135 S Fremont Ave, Springfield, MO 65804-2239 | 2016-12-08 |
| 1821532953 | Lindsi Johnson | Occupational Therapist | 2135 S Fremont Ave, Springfield, MO 65804-2239 | 2016-12-08 |
| 1710437488 | Meredith Hoffmeyer | Nurse Practitioner | 2135 S Fremont Ave, Springfield, MO 65804-2239 | 2016-10-06 |
| 1992191274 | Charles Albritton | Obstetrics & Gynecology | 2135 S Fremont Ave, Springfield, MO 65804-2239 | 2015-04-13 |
| 1821495607 | Totka R. Koutzeva-dussel | Physical Medicine & Rehabilitation | 2135 S Fremont Ave, Springfield, MO 65804 | 2014-11-23 |
| 1871906149 | Megan Jeffris | Specialist/Technologist | 2135 S Fremont Ave, Springfield, MO 65804-2239 | 2014-06-04 |
| 1083033385 | Amy Smith | Specialist/Technologist | 2135 S Fremont Ave, Springfield, MO 65804-2239 | 2014-04-15 |
| 1952743767 | Alexandria Annalicia Jauregui-dusseau | Specialist/Technologist | 2135 S Fremont Ave, Springfield, MO 65804-2239 | 2013-07-22 |
| 1356609051 | Emily Ann Carpenter | Specialist/Technologist | 2135 S Fremont Ave, Springfield, MO 65804-2239 | 2012-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 246Z00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346577731 | Amy Cristine Olden | Specialist/Technologist, Other | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2009-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861874968 | Reece Roberts | Specialist/Technologist, Other | 22486 Michigan Trl, Kirksville, MO 63501-1633 | 2015-06-24 |
| 1003223876 | Sharlletta Jackson | Specialist/Technologist, Other | 505 Highway J North, Hayti, MO 63851 | 2014-07-14 |
| 1912313990 | Dominick Dunn | Specialist/Technologist, Other | 500 Hwy. 61 J. N., Hayti, MO 63851 | 2014-07-10 |
| 1043634488 | Synapse Monitoring Services LLC | Specialist/Technologist, Other | 7404 Heathermoor Ln, O Fallon, MO 63368-7231 | 2014-02-05 |
| 1346412376 | Mid America Balance Institute Inc | Specialist/Technologist, Other | 373 W 101st Terrace, Suite 200, Kansas City, MO 64114 | 2008-03-31 |
| 1386021350 | Astro Neuromonitoring, LLC | Specialist/Technologist, Other | 7404 Heathermoor Ln, 100, O Fallon, MO 63368-7231 | 2015-04-29 |
| 1013318310 | Deanna Marie Bailey | Specialist/Technologist, Other | 2100 Se Blue Pkwy, Lees Summit, MO 64063-1007 | 2014-09-06 |
| 1902212988 | Stacy Drumright | Specialist/Technologist, Other | 500 Highway J, Hayti, MO 63851-1200 | 2014-07-10 |
| 1316234214 | Trease P Ellison | Specialist/Technologist, Other | 3411 Division Dr, West Plains, MO 65775-5789 | 2011-06-30 |
| 1073802609 | Cheri A Vance | Specialist/Technologist, Other | 20 S Sprigg St, Cape Girardeau, MO 63703-6212 | 2011-04-05 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
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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.