Jefferson City Medical Group, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R8640 Issued in MO

Legal business name

JEFFERSON CITY MEDICAL GROUP, PC

Doing business as

JCMG at the Lake

Practice address

5816 Osage Beach Pkwy Ste 105
Osage Beach, MO 65065-3046

Phone

(573) 348-3001

Fax

(573) 348-5998

NPI assigned

Feb 22, 2012

Last updated

Dec 26, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Lee Patrick, MD

Title

President

Phone

(573) 635-5264

Specialties & licenses 1

Addresses

Other names 1

• JCMG at the Lake Doing business as

Locations

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545782400000",
    "number": "1346513207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 104240",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651104240",
            "telephone_number": "573-635-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5816 OSAGE BEACH PKWY STE 105",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653046",
            "telephone_number": "573-348-3001",
            "fax_number": "573-348-5998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON CITY MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-22",
        "last_updated": "2018-12-26",
        "status": "A",
        "authorized_official_last_name": "PATRICK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-635-5264",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R8640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JCMG at the Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JCMG at the Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dylan Hymes, DC
• Adam Lloyd Ilgen, RD, LRD
• Paul Joseph Imperato, CRNA
• Michelle Iwanowicz, COTA/L
• Tammy Leah Jebsen
• Camlyn Jordyn Jeffries, OTR/L
• Stephanie Ann Jenkins, CRNA
• Cleora Katherine Jennings, PHARMD
• Lesa Ann Jobe, COTA
• Molly Elizabeth Johnson, MD

• Internal Medicine Physician in Osage Beach, MO
• Providers in Osage Beach, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.