Jason Matthew Maddox

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2021021904 Issued in MO

Practice address

12680 Olive Blvd Ste 300
Saint Louis, MO 63141-6322

Phone

(314) 251-8888

NPI assigned

Jun 15, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Arizona College of Osteopathic Medicine Mid Western University, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
• Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

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.

• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169

  Single Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  Care Compare affiliation
• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1306414552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12680 OLIVE BLVD STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416322",
            "telephone_number": "314-251-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "JASON",
        "middle_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-15",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2021021904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Eden Maday, FNP
• Sarah Eileen Madden-Peacock
• John C Madden, M.D.
• Amy M Maddin, DVM
• Sreedevi Maddipati, MD
• Lauren Michel Maddox
• Linda Kay Maddox, M.S.
• Thomas Maddox, MD
• Geetha Maddukuri, M.D.
• Made 2 Care in Home Health LLC

• Family Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, 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 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.