NPIMap

Individual provider Active NPI

Reggie A Vaden, MD

  • Colon & Rectal Surgery Physician
  • Columbia, MO
National Provider Identifier
1700983343
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
2014008945 Issued in MO
Practice address
1601 E Broadway
Ste240
Columbia, MO 65201-8020
Phone
(573) 815-8145
Fax
(573) 815-3832
NPI assigned
Sep 17, 2006
Last updated
Feb 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 40886 IA
Surgery Physician 208600000X 2014008946 MO
Colon & Rectal Surgery Physician 208C00000X K8545 TX
Colon & Rectal Surgery Physician 208C00000X 2014008945 MO Primary

Addresses

Primary practice location

1601 E Broadway
Ste240
Columbia, MO 65201-8020

Mailing address

670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141-8573
Phone (573) 815-8145

Other identifiers 6

IdentifierTypeStateIssuer
037011602MedicaidTX
037011605MedicaidTX
037011603MedicaidTX
2014008945OtherMOMO STATE LICENSE
037011604MedicaidTX
1700983343MedicaidMO

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
I20140425001393 MO Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 5294622536 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
University of Arkansas College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

1601 E Broadway
Suite 240
Columbia, MO 65201-8022
Phone (573) 815-8145

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy30
Hernia repair (minimally invasive)1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40886IAMDSurgery Physician
2014008946MOMDSurgery Physician
2014008945MOMDColon & Rectal Surgery Physician
K8545TXMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General John J Pershing Memorial Hospital Association CurrentSince Feb 16, 2026 Accepting new patients
Boone Physician Services, LLC CurrentSince Jan 1, 2021 Accepting new patients
General John J Pershing Memorial Hospital Association CurrentSince Feb 16, 2026 Accepting new patients
Colon & Rectal Clinic, P. a. Colon & Rectal Surgery Past Accepting new patients
Jefferson City Medical Group, P.C. Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
CH Allied Services, Inc. Past Accepting new patients
Village Chiropractic and Wellness P.L.L.C. Past Accepting new patients

Locations

17651 Highway B
Boonville, MO 65233
Phone (660) 882-7461

130 E Lockling St
Brookfield, MO 64628
Phone (660) 258-1050

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1601 E Broadway
Ste 240
Columbia, MO 65201
Phone (573) 815-8145

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

Interoperability endpoints

  • Direct secure messaging: reggievaden@mhccaremail.com

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1700983343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR",
            "address_2": "STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "573-815-8145",
            "fax_number": "573-815-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E BROADWAY",
            "address_2": "STE240",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018020",
            "telephone_number": "573-815-8145",
            "fax_number": "573-815-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADEN",
        "first_name": "REGGIE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "40886",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2014008946",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "TX",
            "license": "K8545",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MO",
            "license": "2014008945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037011602",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037011605",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037011603",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO STATE LICENSE",
            "identifier": "2014008945",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037011604",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700983343",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.