Active NPI
Jody A. Rodgers, M.D.
- Plastic Surgery Physician
- Jefferson City, MO
National Provider Identifier
1093795304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 109997
- Practice address
- 200 Saint Marys Medical PLZ
Suite 301
Jefferson City, MO 65101-1604 - Phone
- (573) 636-9000
- Fax
- (573) 635-2656
- NPI assigned
- Jan 20, 2006
- 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 |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 109997 | MO | Primary |
Addresses
Primary practice location
200 Saint Marys Medical PLZ
Suite 301
Jefferson City, MO 65101-1604
Mailing address
200 Saint Marys Medical PLZ
Suite 301
Jefferson City, MO 65101-1604
Phone (573) 636-9000
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CN2273 | Other | MO | RAILROAD GROUP |
| 208217711 | Medicaid | MO | |
| 112892 | Other | MO | BCBS |
| 240005438 | Other | MO | PALMETTO |
| 293232 | Other | MO | HEALTHLINK |
Other names 1
- Dr. Jody A. Krosnick
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 |
|---|---|---|---|
| 109997 | MO | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274832000000",
"number": "1093795304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 SAINT MARYS MEDICAL PLZ",
"address_2": "SUITE 301",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651011604",
"telephone_number": "573-636-9000",
"fax_number": "573-635-2656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 SAINT MARYS MEDICAL PLZ",
"address_2": "SUITE 301",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651011604",
"telephone_number": "573-636-9000",
"fax_number": "573-635-2656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODGERS",
"first_name": "JODY",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-20",
"last_updated": "2010-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "MO",
"license": "109997",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD GROUP",
"identifier": "CN2273",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "208217711",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "112892",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO",
"identifier": "240005438",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "293232",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JODY",
"last_name": "KROSNICK",
"middle_name": "A.",
"prefix": "DR.",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}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 May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.