NPIMap

Individual provider Active NPI

John Fernando

  • Internal Medicine Physician
  • Columbia, MO
National Provider Identifier
1487049250
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2018023711 Issued in MO
Practice address
1000 W Nifong Blvd Ste 120
Columbia, MO 65203-5615
Phone
(573) 444-6331
Fax
(855) 576-4137
NPI assigned
Mar 30, 2015
Last updated
Nov 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2018023711 MO Primary

Addresses

Primary practice location

1000 W Nifong Blvd Ste 120
Columbia, MO 65203-5615

Mailing address

4508 Royal Lytham Dr
Columbia, MO 65203-5689
Phone (573) 355-2429

Other practice location 1

2505 Mission Dr
Jefferson City, MO 65109
Phone (573) 681-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180815001968 MO Practitioner - Internal Medicine 2567764723 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cole Physician Services LLCGroup PAC ID 0648420810, 23 clinicians

Practice addresses (Care Compare)

1000 W Nifong Blvd
Suite 120
Columbia, MO 65203-5615
Phone (573) 444-6331

2505 Mission Dr
Jefferson City, MO 65109-9508
Phone (573) 681-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018023711MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cole Physician Services LLC CurrentSince Jul 1, 2018 Accepting new patients
Health-1 LLC Internal Medicine CurrentSince Jan 1, 2024 Accepting new patients
Boone Physician Services, LLC CurrentSince Jul 4, 2022 Accepting new patients
Midwest Hospitalist Physicians LLP CurrentSince Sep 15, 2020 Accepting new patients

Locations

1000 W Nifong Blvd
Ste 120
Columbia, MO 65203
Phone (573) 268-5725

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

315 S Osteopathy Ave
Kirksville, MO 63501
Phone (660) 785-1000

1515 Union Ave
Moberly, MO 65270
Phone (660) 263-2400

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JCHGDD/Endpoint/JCHGDD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1487049250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4508 ROYAL LYTHAM DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035689",
            "telephone_number": "573-355-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W NIFONG BLVD STE 120",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035615",
            "telephone_number": "573-444-6331",
            "fax_number": "855-576-4137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2505 Mission Dr",
            "address_purpose": "LOCATION",
            "city": "Jefferson City",
            "state": "MO",
            "postal_code": "65109",
            "country_code": "US",
            "telephone_number": "573-681-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-30",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2018023711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.