Jeffrey W Childers, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2001004971 Issued in MO

Practice address

150 S Mount Auburn Rd
Suite 342
Cape Girardeau, MO 63703-4910

Phone

(573) 335-2212

Fax

(573) 339-5946

NPI assigned

Oct 10, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1174611966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S MOUNT AUBURN RD",
            "address_2": "SUITE 342",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034910",
            "telephone_number": "573-335-2212",
            "fax_number": "573-339-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S MOUNT AUBURN RD",
            "address_2": "SUITE 342",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034910",
            "telephone_number": "573-335-2212",
            "fax_number": "573-339-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "JEFFREY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2001004971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205303019",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chris David Charlton, D.C.
• Christina Speidel Cheek, PLPC
• Ana Barbara Chelse, MD
• Kakeung Charles Cheung, MD
• Raina Childers-Richmond, MS, RD, CHC
• Kara Lynn Chippewa
• Venumadhav Chirunomula, MD
• Karlyle K Christian-Ritter, M.D.
• Michael W Ciaschini, MD
• Elizabeth B Clark, MPT

• Family Medicine Physician in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.