Krishna Kanth R Mettu, MD

Primary specialty

Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X

License

2009008002 Issued in MO

Practice address

1241 W Stadium Blvd
Jefferson City, MO 65109-6023

Phone

(573) 635-5264

Fax

(573) 761-4351

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Sleep MedicineAlso: Neurology

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jefferson City Medical Group PCGroup PAC ID 1850371089, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St. Mary'S Hospital - Jefferson City Hospital, Jefferson City, MO, CCN 260011
• University of Missouri Health Care Hospital, Columbia, MO, CCN 260141

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: krishna.mettu@jcmg.eclinicaldirectplus.com

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.

• Jefferson City Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Jefferson City, MO
  • NPI 1336189398
  Medicare reassignment Care Compare group NPD
• Jefferson City Medical Group, P.C.

  • Hematology & Oncology Physician
  • Jefferson City, MO
  • NPI 1215093257
  NPD
• Jefferson City Medical Group, P.C.

  • Clinical Medical Laboratory
  • Jefferson City, MO
  • NPI 1811292105
  NPD
• Jefferson City Medical Group, P.C.

  • Family Medicine Physician
  • Linn, MO
  • NPI 1083661615
  NPD (past)

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

• Curators of the University of Missouri

  • General Acute Care Hospital
  • Jefferson City, MO
  • NPI 1174597892
  Care Compare affiliation
• Curators of the University of Missouri

  • General Acute Care Hospital
  • Columbia, MO
  • NPI 1699769901
  Care Compare affiliation
• SSM Regional Health Services

  • General Acute Care Hospital
  • Jefferson City, MO
  • NPI 1518065523
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1508977257",
    "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",
            "fax_number": "573-761-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 W STADIUM BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651096023",
            "telephone_number": "573-635-5264",
            "fax_number": "573-761-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METTU",
        "first_name": "KRISHNA",
        "middle_name": "KANTH R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "T2003012955",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "MO",
            "license": "2009008002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508977257",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Mellon, MS, CCC-SLP
• Alecia Mengwasser, REGISTERED NURSE
• Grace Johanna Mengwasser, LMSW
• Menm, LLC
• Elizabeth E Messer, MSN FNP
• Ginger R Meyer, R.D., L.D.
• Nathan P Meyer, CRNA
• Randall E Meyer, MD FACC
• Patricia Michelle D Meyers, FNP
• Michael H. Jones DMD LLC

• Sleep Medicine (Psychiatry & Neurology) Physician in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Sleep Medicine (Psychiatry & Neurology) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; 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.