NPIMap

Individual provider Active NPI

Brandon Lee Jenson, DO

  • Surgery Physician
  • Corydon, IA
National Provider Identifier
1598078677
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
04742 Issued in IA
Practice address
417 S East St
Corydon, IA 50060-1860
Phone
(641) 872-2260
Fax
(641) 872-3643
NPI assigned
Jul 19, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 04742 IA Primary
Surgery Physician 208600000X 2009020184 MO

Addresses

Primary practice location

417 S East St
Corydon, IA 50060-1860

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Other practice location 1

3220 Bluff Creek Dr Ste 100
Columbia, MO 65201-3664
Phone (573) 443-8773

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

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
I20100817000960 MO Practitioner - Emergency Medicine 4981738689 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04742IAMDSurgery Physician
2009020184MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson City Medical Group, P.C. CurrentSince Dec 1, 2023 Accepting new patients
Jefferson City Medical Group, P.C. Current Accepting new patients
Jefferson City Medical Group, P.C. Current Accepting new patients
Knoxville Community Hospital Inc Current Accepting new patients
Jefferson City Medical Group, P.C. CurrentSince Dec 1, 2023 Accepting new patients
SSM Regional Health Services Past Accepting new patients

Locations

1202 W Howard St
Knoxville, IA 50138
Phone (641) 828-7144

1002 S Lincoln St
Knoxville, IA 50138
Phone (641) 842-1464

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

1241 W Stadium Blvd
Jefferson Cty, MO 65109
Phone (573) 556-5771

Interoperability endpoints

  • Direct secure messaging: brandon.jenson@jcmg.eclinicaldirectplus.com

Organizations & group practices 10

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.

Hospital & facility affiliations 1

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

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson City Medical Group PC 117 clinicians

Practice addresses (Care Compare)

1241 W Stadium Blvd
Jefferson City, MO 65109-6023
Phone (573) 556-5771

Hospital & facility affiliations

  • SSM Health St. Mary'S Hospital - Jefferson City Hospital, Jefferson City, MO, CCN 260011

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10

NPI Registry JSON

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1598078677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 S EAST ST",
            "city": "CORYDON",
            "state": "IA",
            "postal_code": "500601860",
            "telephone_number": "641-872-2260",
            "fax_number": "641-872-3643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3220 Bluff Creek Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652013664",
            "country_code": "US",
            "telephone_number": "573-443-8773",
            "fax_number": "573-875-4972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSON",
        "first_name": "BRANDON",
        "middle_name": "LEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-19",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "04742",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2009020184",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "3220 Bluff Creek Dr Ste 100",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652013664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corydon, IA

Sources for this page

Verify at the official NPI Registry.