Active NPI
Kenneth Erich Schafermeyer, DO
- Family Medicine Physician
- Jefferson City, MO
National Provider Identifier
1740339332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R8652
- Practice address
- 2709 Industrial Dr Ste a
Jefferson City, MO 65109-0769 - Phone
- (573) 635-2141
- Fax
- (573) 635-5240
- NPI assigned
- Jan 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R8652 | MO | Primary |
Addresses
Primary practice location
2709 Industrial Dr Ste a
Jefferson City, MO 65109-0769
Mailing address
2709 Industrial Dr Ste a
Jefferson City, MO 65109-0769
Phone (573) 635-2141
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 220102500 | Other | DEPT OF LABOR | |
| 080139723 | Other | RAILROAD PARTNERS | |
| 240811604 | Medicaid | MO | |
| A11730 | Other | PREMIER HEALTH PLAN | |
| 431845485 | Other | PRINCIPAL HEALTH CARE | |
| 431845485 | Other | AMERICAN POSTAL WORKERS | |
| 702803 | Other | HEALTH PARTNERS | |
| 0104044 | Other | UNITED HEALTHCARE | |
| 431845485 | Other | UNITED PAYERS | |
| 431845485 | Other | GENERAL AMERICAN | |
| 431845485 | Other | CIGNA | |
| 431845485 | Other | CENTURY PLANNERS | |
| A11730 | Other | MERCY HEALTH PLAN | |
| 431845485 | Other | AETNA | |
| 8988 | Other | MO | BLUE CROSS |
| 116647 | Other | MO | HEALTH LINK |
| 1703V19251 | Other | HEALTHCARE USA | |
| 58278 | Other | GROUP HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2015 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R8652 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Success Health System, LLC | Past | 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 and National Provider Directory roles.
-
- Psychiatry Physician
- Columbia, MO
- NPI 1508310293
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224720000000",
"number": "1740339332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2709 INDUSTRIAL DR STE A",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651090769",
"telephone_number": "573-635-2141",
"fax_number": "573-635-5240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2709 INDUSTRIAL DR STE A",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651090769",
"telephone_number": "573-635-2141",
"fax_number": "573-635-5240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHAFERMEYER",
"first_name": "KENNETH",
"middle_name": "ERICH",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2008-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "R8652",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR",
"identifier": "220102500",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD PARTNERS",
"identifier": "080139723",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "240811604",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREMIER HEALTH PLAN",
"identifier": "A11730",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRINCIPAL HEALTH CARE",
"identifier": "431845485",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN POSTAL WORKERS",
"identifier": "431845485",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "702803",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0104044",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED PAYERS",
"identifier": "431845485",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GENERAL AMERICAN",
"identifier": "431845485",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "431845485",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CENTURY PLANNERS",
"identifier": "431845485",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY HEALTH PLAN",
"identifier": "A11730",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "431845485",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "8988",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH LINK",
"identifier": "116647",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHCARE USA",
"identifier": "1703V19251",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH PLAN",
"identifier": "58278",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.