NPIMap

Organization Active NPI

Cape Family Medical Clinic, LLC

Doing business as Cape Family Health

  • Rural Health Clinic/Center
  • Cape Girardeau, MO
National Provider Identifier
1720359243
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CAPE FAMILY MEDICAL CLINIC, LLC
Doing business as
Cape Family Health
Practice address
24 N Sprigg St
Cape Girardeau, MO 63701-5526
Phone
(573) 332-7992
Fax
(573) 332-7998
NPI assigned
Jan 13, 2012
Last updated
May 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Authorized official

Name
Jedediah Webster
Title
Owner
Phone
(573) 332-7992

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X MO Primary
Family Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SF0001X

Addresses

Primary practice location

24 N Sprigg St
Cape Girardeau, MO 63701-5526

Mailing address

24 N Sprigg St
Cape Girardeau, MO 63701-5733
Phone (573) 332-7992

Other names 1

  • Cape Family Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120413000298 MO Part A Provider - Rural Health Clinic 4183885403 Practice locations: Cape Girardeau, MO
O20130510000281 MO Part B Supplier - Clinic/Group Practice 4183885403 Receives reassigned benefits from 12 practitioners
2 other NPIs on this enrollment
Practice locations: Altenburg, MO; Cape Girardeau, MO; Perryville, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720359243. Details of each certification follow.

Rural health clinic certification: CCN 263972

Legal name
CAPE FAMILY MEDICAL CLINIC, LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 5, 2003
Last certification
Nov 30, 2020
Ownership / control type
1A
Most recent change of ownership
Oct 13, 2011 (1 total)
Organization structure
LLCProprietary
Incorporated
Sep 20, 2011 in MO
Enrollment address
24 North Sprigg
Cape Girardeau, MO 63701-5526

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Cape Family Health4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jedediah Webster Individual 5% Or Greater Direct Ownership InterestOwner Jul 30, 2021 100%
Corporate OfficerOwner Jul 30, 2021
Corporate DirectorOwner Jul 30, 2021
W-2 Managing EmployeeOwner Jul 30, 2021

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779321600000",
    "number": "1720359243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 N SPRIGG ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637015733",
            "telephone_number": "573-332-7992",
            "fax_number": "573-332-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 N SPRIGG ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637015526",
            "telephone_number": "573-332-7992",
            "fax_number": "573-332-7998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPE FAMILY MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-13",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A",
        "authorized_official_last_name": "WEBSTER",
        "authorized_official_first_name": "JEDEDIAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-332-7992"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MO",
            "license": null,
            "primary": true
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cape Family Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.