Individual provider Active NPI

Serese Yvonne Smith-Haxton, MD

  • Obstetrics & Gynecology Physician
  • Jefferson City, MO
National Provider Identifier
1518048735
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2009035426 Issued in MO
Practice address
1125 Madison St
Jefferson City, MO 65101-5227
Phone
(573) 632-5510
Fax
(573) 632-5810
NPI assigned
Oct 17, 2006
Last updated
Feb 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X KS 04-31151 KS
Obstetrics & Gynecology Physician 207V00000X 2009035426 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) 632-5510

Other identifiers 2

IdentifierTypeStateIssuer
1518048735MedicaidMO
100447000DMedicaidKS

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
I20040120000302 MO Practitioner - Obstetrics/Gynecology 8022919273 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Missouri, Kansas City, School of Medicine, 1990
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

State licenses

LicenseStateTypeSpecialty
KS 04-31151KSMDObstetrics & Gynecology Physician
2009035426MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
Community Health Ctr of Central Missouri Current Accepting new patients
Community Health Ctr of Central Missouri CurrentSince Oct 14, 2014 Accepting new patients
Metropolitan OB-GYN Associates, LLC Obstetrics & Gynecology Past Accepting new patients
Care for Women, LLC Obstetrics & Gynecology Past Accepting new patients
Providence Care Inc Obstetrics & Gynecology Past Accepting new patients
Women's Health Specialists, P.a. Obstetrics & Gynecology Past Accepting new patients
Capital Region Medical Center Past Accepting new patients
Curators of the University of Missouri Past Accepting new patients
Midwest Metropolitan Physicians Group LLC Past Accepting new patients

Locations

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

1014 Madison St
Jefferson Cty, MO 65101
Phone (573) 632-5510

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

1511 Christy Dr
Jefferson Cty, MO 65101
Phone (573) 606-6924

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

Organizations & group practices 11

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 2

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1518048735",
    "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": "573-632-5510",
            "fax_number": "573-632-5810"
        },
        {
            "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": "573-632-5510",
            "fax_number": "573-632-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-HAXTON",
        "first_name": "SERESE",
        "middle_name": "YVONNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KS",
            "license": "KS 04-31151",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2009035426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518048735",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100447000D",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.