CMMP Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

95-6 Issued in MO

Legal business name

CMMP SURGICAL CENTER LLC

Practice address

1705 Christy Dr
Ste 100
Jefferson City, MO 65101-5195

Phone

(573) 635-7022

Fax

(573) 659-5443

NPI assigned

Jun 1, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Carl R Doerhoff, M.D.

Title

Majority Physician Owner

Phone

(573) 659-5401

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Listed as

CMMP Surgical Center LLCCCN 26C0001042

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1528060704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 CHRISTY DR",
            "address_2": "STE 100",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015195",
            "telephone_number": "573-635-7022",
            "fax_number": "573-659-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 CHRISTY DR",
            "address_2": "STE 100",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015195",
            "telephone_number": "573-635-7022",
            "fax_number": "573-659-5443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMMP SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "DOERHOFF",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MAJORITY PHYSICIAN OWNER",
        "authorized_official_telephone_number": "573-659-5401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": "95-6",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PROV NUMBER",
            "identifier": "537147",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HLTH CARE PROV NUM",
            "identifier": "6800140",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MO PROV NUMBER",
            "identifier": "37",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casey Claypool, MHS, CF-SLP
• John W Clemens, M.D.
• Melissa Victoria Clemons, DC
• Michelle R Cline, OTR
• Torey Clogston, DPT
• Walter Christopher Coats, DO
• Keri Cobb
• Benjamin Lloyd Coe, PHD, DNP, APRN, RN
• Nathan Hamadeh Cofrancisco, MD
• Virginia Cogdill, FNP

• Ambulatory Surgical Clinic/Center in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Ambulatory Surgical Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.