NPIMap

Organization Active NPI

Capital Region Medical Center

  • Family Medicine Physician
  • Jefferson City, MO
National Provider Identifier
1104001676
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CAPITAL REGION MEDICAL CENTER
Practice address
420 E High St
Jefferson City, MO 65101-3215
Phone
(573) 635-0916
Fax
(573) 635-8812
NPI assigned
Jan 3, 2008
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Tom Luebbering
Title
VP of Finance
Phone
(573) 632-5100

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

420 E High St
Jefferson Cty, MO 65101
Phone (573) 635-0916

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

420 E High St
Jefferson City, MO 65101-3215

Mailing address

420 E High St
Jefferson City, MO 65101-3215
Phone (573) 635-0916

Other names 1

NPPES NPI Registry
  • Capital Region Physicians - Family Medical Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 23, 2013.

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377216000000",
    "number": "1104001676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E HIGH ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013215",
            "telephone_number": "573-635-0916",
            "fax_number": "573-635-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E HIGH ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013215",
            "telephone_number": "573-635-0916",
            "fax_number": "573-635-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL REGION MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2013-08-23",
        "status": "A",
        "authorized_official_last_name": "LUEBBERING",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "573-632-5100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital Region Physicians - Family Medical Center",
            "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 23, 2013; 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.