Jonathan Lee Minor, M.D.

Primary specialty

Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X

License

A137057 Issued in CA

Practice address

910 W 10TH St
Rolla, MO 65409-6519

Phone

(573) 342-4284

Fax

(573) 341-6967

NPI assigned

May 19, 2010

Last updated

Mar 30, 2026By the provider in NPPES

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 AZ, OR2 enrollments

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 2

Specialty

HospitalistAlso: Pediatric Medicine

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Sports Medicine LLCGroup PAC ID 6800228479, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jon.minor@43033389170692.direct.elationemr.com

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.

• Modern Sports Medicine LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Sun Lakes, AZ
  • NPI 1285295089
  Medicare reassignment Care Compare group NPD
• Cardiac Fitness and Recovery

  • Internal Medicine Physician
  • Tucson, AZ
  • NPI 1114817616
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  OR

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AZ

  Medicare reassignment NPD
• TMC Medical Network

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1750832283
  Medicare reassignment NPD
• Modern Sports Medicine LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Tucson, AZ
  • NPI 1609662709
  NPD
• Sparcc Professional Corporation

  dba Sparcc

  • Sports Medicine (Internal Medicine) Physician
  • Tucson, AZ
  • NPI 1003275413
  NPD (past)
• Tucson Concussion Center LLC

  • Adolescent Medicine (Family Medicine) Physician
  • Tucson, AZ
  • NPI 1114306917
  NPD (past)

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1609195452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654096519",
            "telephone_number": "573-342-4284",
            "fax_number": "573-341-6967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654096519",
            "telephone_number": "573-342-4284",
            "fax_number": "573-341-6967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "JONATHAN",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-19",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "CA",
            "license": "A137057",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2020036607",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CB238713",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Midwest Chiropractic Center LLC
• Midwest Heart Group of Rolla, LLC
• Vera Mikhailova, MD
• Joshua Ryan Miller, DO
• Margaret P. Miller, L.C.S.W.
• Miracl, LLC
• Miracl, LLC
• Haley Misner
• Missouri CVS Pharmacy LLC (CVS Pharmacy #10280)
• Missouri Home Care (An Auxi Health Company)

• Pediatric Sports Medicine Physician in Rolla, MO
• Providers in Rolla, MO by specialty
• Pediatric Sports Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.