Individual provider Active NPI

Lisa Gerette Kolb, M.D.

  • Nephrology Physician
  • Jefferson City, MO
National Provider Identifier
1336135276
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
106050 Issued in MO
Practice address
1125 Madison St
Jefferson City, MO 65101-5227
Phone
(573) 634-2620
Fax
(573) 634-2033
NPI assigned
Sep 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 106050 MO Primary

Addresses

Primary practice location

1125 Madison St
Jefferson City, MO 65101-5227

Mailing address

1125 Madison St
Jefferson City, MO 65101-5227
Phone (573) 634-2620

Other identifiers 2

IdentifierTypeStateIssuer
110095712OtherMORAILROAD MEDICARE
206994907MedicaidMO

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080805000627 MO Practitioner - NephrologyPractitioner - Internal Medicine 2567552912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Missouri, Columbia School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1125 Madison St
Jefferson City, MO 65101-5227
Phone (573) 635-7141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
The Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
Capital Region Medical Center Past Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

1505 Southwest Blvd
Jefferson Cty, MO 65109
Phone (573) 632-5570

1125 Madison St
Jefferson Cty, MO 65101
Phone (573) 632-5000

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

901 Kidwell Dr
Versailles, MO 65084
Phone (573) 378-4666

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1336135276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 MADISON ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015227",
            "telephone_number": "573-634-2620",
            "fax_number": "573-634-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 MADISON ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015227",
            "telephone_number": "573-634-2620",
            "fax_number": "573-634-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLB",
        "first_name": "LISA",
        "middle_name": "GERETTE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "106050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110095712",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206994907",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.