Individual provider Active NPI

Edward J Gerber, PA-C

  • Physician Assistant
  • Jefferson City, MO
National Provider Identifier
1710966148
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2006037125 Issued in MO
Practice address
2505 Mission Dr
Suite 200
Jefferson City, MO 65109-9508
Phone
(573) 681-3759
Fax
(573) 681-3659
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2006037125 MO Primary

Addresses

Primary practice location

2505 Mission Dr
Suite 200
Jefferson City, MO 65109-9508

Mailing address

2505 Mission Dr
Suite 200
Jefferson City, MO 65109-9508
Phone (573) 681-3759

Other practice location 1

One Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-8091

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address egerber91789@direct-ehr-ssmhc.com Direct
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071210000497 MO Practitioner - Physician Assistant 9537125901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-2100

1020 Hitt St
Columbia, MO 65212-0001

1100 Virginia Ave
Columbia, MO 65212-0001
Phone (573) 882-2667

3302 W Broadway a
Columbia, MO 65203-0001
Phone (573) 882-6742

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2006037125MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Curators of the University of Missouri CurrentSince Apr 1, 2017 Accepting new patients
Orthopaedic Center of Illinois Past Accepting new patients
SSM Regional Health Services Past Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

100 Saint Marys Plz
Jefferson Cty, MO 65101
Phone (573) 635-7642

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1710966148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 MISSION DR",
            "address_2": "SUITE 200",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651099508",
            "telephone_number": "573-681-3759",
            "fax_number": "573-681-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 MISSION DR",
            "address_2": "SUITE 200",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651099508",
            "telephone_number": "573-681-3759",
            "fax_number": "573-681-3659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652120001",
            "country_code": "US",
            "telephone_number": "573-882-8091",
            "fax_number": "573-884-1902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERBER",
        "first_name": "EDWARD",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2006037125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2505 Mission Dr",
            "address_2": "Suite 200",
            "city": "Jefferson City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "651099508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "egerber91789@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "egerber91789@direct-ehr-ssmhc.com",
            "address_1": "2505 Mission Dr",
            "address_2": "Suite 200",
            "city": "Jefferson City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "651099508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "One Hospital Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652120001",
            "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.