Individual provider Active NPI

Jerry Karr, DO

  • Emergency Medicine Physician
  • Washington, MO
National Provider Identifier
1174505481
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
101878 Issued in MO
Practice address
901 E 5TH St
Washington, MO 63090-3127
Phone
(636) 239-8011
Fax
(636) 390-7296
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 03217 IA
Emergency Medicine Physician 207P00000X 101878 MO Primary

Addresses

Primary practice location

901 E 5TH St
Washington, MO 63090-3127

Mailing address

PO Box 18057B
Saint Louis, MO 63150-8057
Phone (636) 239-8011

Other identifiers 5

IdentifierTypeStateIssuer
1174505481MedicaidMO
49428OtherIABX
0191882MedicaidIA
930097243OtherIARRMC
P00889535OtherMORAILROAD MEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100505000880 MO Practitioner - Emergency Medicine 9234120346 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
03217IAMDBasic Emergency Medical Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Perry CurrentSince Oct 1, 2023 Accepting new patients
Mercy Hospitals East Communities CurrentSince Feb 8, 2010 Accepting new patients
Texas County Memorial Hospital CurrentSince Oct 15, 2020 Accepting new patients
Mercy Hospital Perry Emergency Medicine CurrentSince Oct 1, 2023 Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Feb 8, 2010 Accepting new patients
Mercy Hospital Lincoln CurrentSince Jul 1, 2019 Accepting new patients
Texas County Memorial Hospital Emergency Medicine CurrentSince Oct 15, 2020 Accepting new patients

Locations

1333 S Sam Houston Blvd
Houston, MO 65483
Phone (417) 967-3311

434 N West St
Perryville, MO 63775
Phone (573) 547-2530

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

901 Patients First Dr
#1200
Washington, MO 63090
Phone (636) 390-1777

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1174505481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18057B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631508057",
            "telephone_number": "636-239-8011",
            "fax_number": "636-390-7296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E 5TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903127",
            "telephone_number": "636-239-8011",
            "fax_number": "636-390-7296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARR",
        "first_name": "JERRY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2015-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "IA",
            "license": "03217",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "101878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174505481",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BX",
            "identifier": "49428",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0191882",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "930097243",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00889535",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

Verify at the official NPI Registry.