Active NPI
Jeremy Matthew Gebhardt, PA-C
- Physician Assistant
- Columbia, MO
National Provider Identifier
1801266259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2021036929
- Practice address
- 1 Hospital Dr
Columbia, MO 65212-0001 - Phone
- (573) 882-6500
- Fax
- (573) 884-0437
- NPI assigned
- Sep 29, 2015
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2021036929 | MO | Primary |
Addresses
Primary practice location
1 Hospital Dr
Columbia, MO 65212-0001
Mailing address
PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2015035959 | Other | MO | STATE LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1801266259",
"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": "1 HOSPITAL DR",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652120001",
"telephone_number": "573-882-6500",
"fax_number": "573-884-0437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEBHARDT",
"first_name": "JEREMY",
"middle_name": "MATTHEW",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-29",
"last_updated": "2022-08-23",
"certification_date": "2021-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "2021036929",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "2015035959",
"state": "MO"
}
],
"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": "1 Hospital Dr",
"city": "Columbia",
"state": "MO",
"country_code": "US",
"postal_code": "652120001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.