NPIMap

Organization Active NPI

Juno Group LLC

  • Obstetrics & Gynecology Physician
  • Joplin, MO
National Provider Identifier
1255634275
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2003008358 Issued in MO
Legal business name
JUNO GROUP LLC
Practice address
3103 McClelland Blvd
Joplin, MO 64804-1640
Phone
(417) 624-2621
Fax
(417) 624-4652
NPI assigned
Dec 14, 2010
Last updated
May 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2011

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

Authorized official

Name
Dr. Cheryl Ann Fogarty, M.D.NPI 1316974207
Title
Owner
Phone
(417) 624-2621

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2003008358 MO Primary

Addresses

Primary practice location

3103 McClelland Blvd
Joplin, MO 64804-1640

Mailing address

PO Box 3535
Joplin, MO 64803-3535
Phone (417) 624-2621

Other identifiers 2

IdentifierTypeStateIssuer
200317670AMedicaidOK
1255634275MedicaidMO

National Provider Directory

National Provider Directory

Locations

2620 Cunningham Ave
Joplin, MO 64804
Phone (417) 624-2621

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306195200000",
    "number": "1255634275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3535",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648033535",
            "telephone_number": "417-624-2621",
            "fax_number": "417-624-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 MCCLELLAND BLVD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041640",
            "telephone_number": "417-624-2621",
            "fax_number": "417-624-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUNO GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-14",
        "last_updated": "2011-05-24",
        "status": "A",
        "authorized_official_last_name": "FOGARTY",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-624-2621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2003008358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200317670A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255634275",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; 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.