Jefferson Manor

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

041432 Issued in MO

Legal business name

JEFFERSON MANOR

Practice address

902 Jefferson Ave
Cape Girardeau, MO 63703-6755

Phone

(573) 651-1373

Fax

(573) 651-1373

NPI assigned

Mar 17, 2015

Last updated

Mar 17, 2015By 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

Ms. Sharon Louise Armour

Title

Operator

Phone

(573) 651-1373

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1417340357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 JEFFERSON AVE",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036755",
            "telephone_number": "573-651-1373",
            "fax_number": "573-651-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 JEFFERSON AVE",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036755",
            "telephone_number": "573-651-1373",
            "fax_number": "573-651-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "ARMOUR",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OPERATOR",
        "authorized_official_telephone_number": "573-651-1373",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "041432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn J Jansen, PA-C
• Pairote Jaroonwanichkul, MD
• Mary Elizabeth Jarrells, FNP-BC
• Wendy Maria Jauch, APRN
• Michael T Jedlinski, M.D.
• Jefferson Manor Cape Girardeau
• Curtis Alvin Jefferson, ATC
• Lisa Jeffords
• Dinia R Jenkins, LPC
• Rachael Marie Jenkins, APRN, FNP-BC

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.