Active NPI
Janet E Theby, MD
- Family Medicine Physician
- Jefferson City, MO
National Provider Identifier
1801874243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 105073
- Practice address
- 2707 W Edgewood Dr
Jefferson City, MO 65109-5888 - Phone
- (573) 635-0233
- Fax
- (573) 635-7436
- NPI assigned
- Jan 5, 2006
- Sex
- Female
- 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 | 105073 | MO | Primary |
Addresses
Primary practice location
2707 W Edgewood Dr
Jefferson City, MO 65109-5888
Mailing address
2707 W Edgewood Dr
Jefferson City, MO 65109-5888
Phone (573) 635-0233
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1196653 | Other | FIRST HEALTH | |
| 206878258 | Medicaid | MO | |
| 508069101 | Medicaid | MO | |
| 241056 | Other | HEALTHLINK | |
| B08074 | Other | MERCY | |
| CH5818 | Other | RR MEDICARE | |
| 080193832 | Other | RR MEDICARE | |
| 44 0546366 | Other | UNITED HEALTHCARE | |
| 501607808 | Medicaid | MO | |
| 25147 | Other | BLUE CROSS BLUE SHIELD | |
| CD6730 | Other | RR MEDICARE | |
| P00099221 | Other | RR MEDICARE | |
| 206878233 | Medicaid | MO | |
| 206878241 | Medicaid | MO | |
| 4640661 | Other | CIGNA | |
| 500383609 | Medicaid | MO | |
| CK7821 | Other | RR MEDICARE | |
| 080187712 | Other | RR MEDICARE |
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Curators of the University of Missouri | 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.
-
- Multi-Specialty Clinic/Center
- Columbia, MO
- NPI 1235126921
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379980800000",
"number": "1801874243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2707 W EDGEWOOD DR",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651095888",
"telephone_number": "573-635-0233",
"fax_number": "573-635-7436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2707 W EDGEWOOD DR",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651095888",
"telephone_number": "573-635-0233",
"fax_number": "573-635-7436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEBY",
"first_name": "JANET",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-05",
"last_updated": "2013-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "105073",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "1196653",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "206878258",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "508069101",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "241056",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY",
"identifier": "B08074",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CH5818",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "080193832",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "44 0546366",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "501607808",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "25147",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CD6730",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00099221",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "206878233",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "206878241",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "4640661",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500383609",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CK7821",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "080187712",
"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 Sep 24, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.