Active NPI
Barbara J. Tellerman, M.D.
- Diagnostic Radiology Physician
- Columbia, MO
National Provider Identifier
1093702185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- R3M06
- Practice address
- 1600 E Broadway
Columbia, MO 65201-5844 - Phone
- (573) 815-8000
- Fax
- (573) 815-6343
- NPI assigned
- Oct 4, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | R3M06 | MO | Primary |
Addresses
Primary practice location
1600 E Broadway
Columbia, MO 65201-5844
Mailing address
PO Box 3242
Indianapolis, IN 46206-3242
Phone (844) 295-4873
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203084306 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R3M06 | MO | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493683200000",
"number": "1093702185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3242",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462063242",
"telephone_number": "844-295-4873",
"fax_number": "844-839-0626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 E BROADWAY",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652015844",
"telephone_number": "573-815-8000",
"fax_number": "573-815-6343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TELLERMAN",
"first_name": "BARBARA",
"middle_name": "J.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-04",
"last_updated": "2017-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "R3M06",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "203084306",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.