Individual provider Active NPI

Jason Shaver, PA-C

  • Physician Assistant
  • Springfield, MO
National Provider Identifier
1013231950
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2017027196 Issued in MO
Practice address
3800 S National Ave Ste 510
Springfield, MO 65807-5284
Phone
(417) 875-3114
Fax
(417) 875-3922
NPI assigned
Mar 22, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085003699 IL
Physician Assistant 363A00000X PA9106343 FL
Physician Assistant 363A00000X 2017027196 MO Primary

Addresses

Primary practice location

3800 S National Ave Ste 510
Springfield, MO 65807-5284

Mailing address

PO Box 9007
Springfield, MO 65808-9007
Phone (417) 875-3000

Other identifiers 2

IdentifierTypeStateIssuer
220045444MedicaidMO
1013231950MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170808003946 MO Practitioner - Physician Assistant 4789834540 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 1254248917, 336 clinicians

Practice addresses (Care Compare)

1000 E Primrose St
Suite 360
Springfield, MO 65807-5293
Phone (417) 269-4037

1001 E Primrose St
Springfield, MO 65807-5155

3800 S National Ave
Suite 400
Springfield, MO 65807-5272
Phone (417) 875-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.52 of 100Reported as group
Quality
61.64
Promoting interoperability
100
Improvement activities
40
Cost
76.77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Jan 1, 2018 Accepting new patients
Lester E Cox Medical Centers CurrentSince Jan 1, 2018 Accepting new patients
Lester E Cox Medical Centers CurrentSince Jan 1, 2018 Accepting new patients
Lester E Cox Medical Centers CurrentSince Jul 1, 2022 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients

Locations

5100 N Towne Centre Dr
Ozark, MO 65721
Phone (417) 269-2215

3800 S National Ave
Ste 510
Springfield, MO 65807
Phone (417) 875-3114

1000 E Primrose St
Ste 360
Springfield, MO 65807
Phone (417) 269-4037

3800 S National Ave
Ste 400
Springfield, MO 65807
Phone (417) 269-9482

3801 S National Ave
Fl 5
Springfield, MO 65807

1001 E Primrose St
Springfield, MO 65807
Phone (417) 875-3434

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1013231950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658089007",
            "telephone_number": "417-875-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 S NATIONAL AVE STE 510",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075284",
            "telephone_number": "417-875-3114",
            "fax_number": "417-875-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAVER",
        "first_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-22",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003699",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106343",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2017027196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220045444",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013231950",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.