NPIMap

Organization Active NPI

SSM Regional Health Services

Doing business as SSM Health Vascular Center

  • Medical Specialty Clinic/Center
  • Jefferson City, MO
National Provider Identifier
1679961577
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
SSM REGIONAL HEALTH SERVICES
Doing business as
SSM Health Vascular Center
Practice address
2505 Mission Dr Ste 130
Jefferson City, MO 65109-9508
Phone
(573) 681-3585
Fax
(573) 681-3665
NPI assigned
Dec 30, 2014
Last updated
May 22, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SSM REGIONAL HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Authorized official

Name
James Stratton
Title
Cfo
Phone
(573) 681-3129

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X NU Primary

Addresses

Primary practice location

2505 Mission Dr Ste 130
Jefferson City, MO 65109-9508

Mailing address

PO Box 1027
Jefferson City, MO 65102-1027
Phone (573) 681-3767

Other names 1

  • SSM HEALTH VASCULAR CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070213000635 MO Part B Supplier - Clinic/Group Practice 8921917352 Receives reassigned benefits from 64 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jefferson City, MO

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
St Marys Health Center

NPI Registry JSON

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590105600000",
    "number": "1679961577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1027",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651021027",
            "telephone_number": "573-681-3767",
            "fax_number": "573-761-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 MISSION DR STE 130",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651099508",
            "telephone_number": "573-681-3585",
            "fax_number": "573-681-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM REGIONAL HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM REGIONAL HEALTH SERVICES",
        "enumeration_date": "2014-12-30",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A",
        "authorized_official_last_name": "STRATTON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-681-3129"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM HEALTH VASCULAR CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM HEALTH VASCULAR CENTER",
            "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 May 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.