NPIMap

Organization Active NPI

Capital Region Medical Center

  • Family Medicine Physician
  • Jefferson City, MO
National Provider Identifier
1679701296
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CAPITAL REGION MEDICAL CENTER
Practice address
3308 W Edgewood
Suite B
Jefferson City, MO 65109
Phone
(573) 644-6999
Fax
(573) 644-7880
NPI assigned
Jun 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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

Authorized official

Name
Tom Luebbering
Title
VP of Finance
Phone
(573) 632-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3308 W Edgewood
Suite B
Jefferson City, MO 65109

Mailing address

PO Box 1128
Jefferson City, MO 65102-1128
Phone (573) 644-6999

Other names 1

  • Capital Region Physicians - Primary Care Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Capital Region Medical Center47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1679701296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1128",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651021128",
            "telephone_number": "573-644-6999",
            "fax_number": "573-644-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 W EDGEWOOD",
            "address_2": "SUITE B",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "65109",
            "telephone_number": "573-644-6999",
            "fax_number": "573-644-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL REGION MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-23",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "LUEBBERING",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "573-632-5100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital Region Physicians - Primary Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.