Individual provider Active NPI

Tawnyia Jerome, M.D.

  • Family Medicine Physician
  • Jefferson City, MO
National Provider Identifier
1710955760
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
118133 Issued in MO
Practice address
3527 W Truman Blvd
Jefferson City, MO 65109-5901
Phone
(573) 882-8910
Fax
(573) 884-1585
NPI assigned
Mar 8, 2006
Last updated
May 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 118133 MO Primary

Addresses

Primary practice location

3527 W Truman Blvd
Jefferson City, MO 65109-5901

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Other identifiers 9

IdentifierTypeStateIssuer
2194853OtherFIRST HEALTH
440546366OtherUNITED HEALTH CARE
5512885OtherCCN
G69424OtherMERCY
P00134687OtherRR MEDICARE
2904972OtherCIGNA
126471OtherBLUE CROSS BLUE SHIELD
204642433MedicaidMO
410414OtherHEALTHLINK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040709000083 MO Practitioner - Family Practice 6204814049

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118133MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Curators of the University of Missouri Family Medicine PastSince Mar 1, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1710955760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3527 W TRUMAN BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095901",
            "telephone_number": "573-882-8910",
            "fax_number": "573-884-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEROME",
        "first_name": "TAWNYIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "118133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2194853",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "440546366",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN",
            "identifier": "5512885",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "G69424",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00134687",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2904972",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "126471",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204642433",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "410414",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "3527 W Truman Blvd",
            "city": "Jefferson City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "651095901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.