Theodore Martin Willmore, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2000153519 Issued in MO

Practice address

100 Saint Marys PLZ
Jefferson City, MO 65101-1602

Phone

(573) 761-7011

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Merit-based Incentive Payment System (MIPS)

Final score

83.47 of 100Reported as group

Quality

79.53

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Capital Emergency Physicians, PC

  • Emergency Medicine Physician
  • Jefferson City, MO
  • NPI 1871626309
  Medicare reassignment NPD

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354838400000",
    "number": "1720194491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 BIG SUR BLVD",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652036704",
            "telephone_number": "573-447-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SAINT MARYS PLZ",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651011602",
            "telephone_number": "573-761-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLMORE",
        "first_name": "THEODORE",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2012-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2000153519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donnetta Lynn Wilkerson, PHYSICAL THERAPIST
• Desiree Williams
• Hannah Williams, PT, DPT
• Sarah Jane Williams, PMHNP-BC
• Yolanda E Williams, NP
• Anna Michaele Wilson, MSW, LCSW
• Baylee Wilson, LCSW
• Che Wilson, LMSW
• Dustin C Wilson, DDS, MS
• Jamie Lynn Wilson, LMSW

• Emergency Medicine Physician in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.