Organization Active NPI

Jan Seabaugh MD LLC

  • Otolaryngology Physician
  • Columbia, MO
National Provider Identifier
1679933188
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
JAN SEABAUGH MD LLC
Practice address
3315 Berrywood Dr
Suite 207
Columbia, MO 65201-6571
Phone
(573) 815-9062
Fax
(573) 443-1162
NPI assigned
Feb 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Authorized official

Name
Janice L Seabaugh, MD
Title
Physician
Phone
(573) 815-9062

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

3315 Berrywood Dr
Suite 207
Columbia, MO 65201-6571

Mailing address

3315 Berrywood Dr
Suite 207
Columbia, MO 65201-6571
Phone (573) 815-9062

Other identifiers 1

IdentifierTypeStateIssuer
1134187487MedicaidMO

National Provider Directory

National Provider Directory

Locations

3315 Berrywood Dr
Ste 207
Columbia, MO 65201
Phone (573) 815-0662

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1679933188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 BERRYWOOD DR",
            "address_2": "SUITE 207",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016571",
            "telephone_number": "573-815-9062",
            "fax_number": "573-443-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 BERRYWOOD DR",
            "address_2": "SUITE 207",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016571",
            "telephone_number": "573-815-9062",
            "fax_number": "573-443-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAN SEABAUGH MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-25",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "SEABAUGH",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "573-815-9062",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134187487",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; 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.