NPIMap

Organization Active NPI

Capital Region Medical Center

Doing business as Capital Region Corporate Health Clinic

  • Multi-Specialty Clinic/Center
  • Jefferson City, MO
National Provider Identifier
1023081767
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
4199 Issued in MO
Legal business name
CAPITAL REGION MEDICAL CENTER
Doing business as
Capital Region Corporate Health Clinic
Practice address
1500 Southwest Blvd
Ste C
Jefferson City, MO 65109
Phone
(573) 632-5786
Fax
(573) 632-5833
NPI assigned
Feb 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
James R McMillan
Title
VP Finance
Phone
(573) 632-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 4199 MO Primary

Addresses

Primary practice location

1500 Southwest Blvd
Ste C
Jefferson City, MO 65109

Mailing address

1500 Southwest Blvd
Ste C
Jefferson City, MO 65109
Phone (573) 632-5786

Other names 1

  • Capital Region Corporate Health Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Capital Region Medical Center47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

Locations

1500 Southwest Blvd
Ste C
Jefferson Cty, MO 65109
Phone (573) 632-5786

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023081767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 SOUTHWEST BLVD",
            "address_2": "STE C",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "65109",
            "telephone_number": "573-632-5786",
            "fax_number": "573-632-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SOUTHWEST BLVD",
            "address_2": "STE C",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "65109",
            "telephone_number": "573-632-5786",
            "fax_number": "573-632-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL REGION MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCMILLAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "573-632-5100"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MO",
            "license": "4199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital Region Corporate Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.