NPIMap

Organization Active NPI

Capital Region Medical Center

Doing business as Capital Region Physicians - Miller Clinic

  • Family Medicine Physician
  • Jefferson City, MO
National Provider Identifier
1255762852
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CAPITAL REGION MEDICAL CENTER
Doing business as
Capital Region Physicians - Miller Clinic
Practice address
1705 Christy Dr
Suite 201
Jefferson City, MO 65101-5195
Phone
(573) 635-0621
Fax
(573) 635-3534
NPI assigned
Dec 6, 2013
Last updated
Dec 6, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Authorized official

Name
Tom Luebbering
Title
Vice President of Finance
Phone
(573) 632-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1705 Christy Dr
Suite 201
Jefferson City, MO 65101-5195

Mailing address

1705 Christy Dr
Suite 201
Jefferson City, MO 65101-5195
Phone (573) 635-0621

Other names 1

  • Capital Region Physicians - Miller Clinic Doing business as

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

NPI Registry JSON

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1255762852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 CHRISTY DR",
            "address_2": "SUITE 201",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015195",
            "telephone_number": "573-635-0621",
            "fax_number": "573-635-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 CHRISTY DR",
            "address_2": "SUITE 201",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015195",
            "telephone_number": "573-635-0621",
            "fax_number": "573-635-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL REGION MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-06",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "LUEBBERING",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "573-632-5100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital Region Physicians - Miller Clinic",
            "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 Dec 6, 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.