Individual provider Active NPI

David Stephen Carron, D.P.M

  • Podiatrist
  • Jefferson City, MO
National Provider Identifier
1174569883
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
MO000667 Issued in MO
Practice address
3207 W Truman Blvd
Suite C
Jefferson City, MO 65109-0578
Phone
(573) 659-2376
Fax
(573) 893-3342
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X MO000667 MO Primary

Addresses

Primary practice location

3207 W Truman Blvd
Suite C
Jefferson City, MO 65109-0578

Mailing address

3207 W Truman Blvd
Suite C
Jefferson City, MO 65109-0578
Phone (573) 659-2376

Other identifiers 7

IdentifierTypeStateIssuer
20-1117309OtherMERCY
25894OtherBLUE CROSS BLUE SHIELD
30691215MedicaidMO
4565615OtherAETNA
20-1117309OtherGHP
248520OtherHEALTHLINK
P00344559OtherMORAILROAD 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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060814000200 MO Practitioner - Podiatry 4981607934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1991
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3207 W Truman Blvd
Suite C
Jefferson City, MO 65109-0892

Merit-based Incentive Payment System (MIPS)

Final score
98.38 of 100Reported as individual
Quality
91.66
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue37
Removal of nail tissue1257
Removal or shaving of skin growth900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MO000667MOMDPodiatrist

Interoperability endpoints

  • Direct secure messaging: davidscarron@fhc.ssdirect.aprima.com

Organizations & group practices 1

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1174569883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3207 W TRUMAN BLVD",
            "address_2": "SUITE C",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651090578",
            "telephone_number": "573-659-2376",
            "fax_number": "573-893-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3207 W TRUMAN BLVD",
            "address_2": "SUITE C",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651090578",
            "telephone_number": "573-659-2376",
            "fax_number": "573-893-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRON",
        "first_name": "DAVID",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MO",
            "license": "MO000667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "20-1117309",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "25894",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30691215",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4565615",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "20-1117309",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "248520",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00344559",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.