SSM Regional Health Services
Organization Active NPI Urgent Care Clinic/Center · Jefferson City, MO
NPI 1831288869 · NPPES record last updated Dec 16, 2025
Key facts
- NPI
- 1831288869
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- SSM REGIONAL HEALTH SERVICES
- Practice address
- 2511 W Edgewood Dr
Suite D
Jefferson City, MO 65109-5869 - Phone
- (573) 761-0304
- Fax
- (573) 635-0726
- NPI assigned
- Oct 11, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SSM REGIONAL HEALTH SERVICES
Authorized official
- Name
- Shasta Rene Manuel
- Title
- Regional Vice President Finance/Cfo
- Phone
- (405) 272-7282
Owned or controlled facilities with NPI records 8
Other NPIs with the same Medicare PAC ID 12
Practitioners 166
-
Whitney N Bahner, FNP-C
-
Allison F Bax, FNP
-
Sandra Brenner, FNP
-
Paul E. Burris, FNP-C
-
Michelle Leigh Felten, FNP-C
-
Julie Ann Miller, FNP-BC
-
Purvi G. Patel, M.D.
-
Christopher Aaron Paynter, D.O., M.S.
-
Garry D Pearson, D.O.
-
Ginger Elizabeth Protzman, FNP-BC
-
Christina Ann Williams, NP-C
-
Joanna Younker, D.O.
-
Steven D Martin, M.D.
-
Treesa Renee Riedel, MSN, APRN, FNP-C
-
Olga Brea Pena, M.D.
-
Donna Marie Adams, LPC
-
John Gramling Adams Jr., M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D1064160 | SSM Health Urgent Care- Jefferson City | Certificate of waiver | Aug 23, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
All facility ownership & control disclosures 8
| Facility | Type | Role | Since |
|---|---|---|---|
| SSM Health St Marys Hospital Jefferson City |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2000 |
| SSM Health Good Samaritan Hospital - Mt. Vernon |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Sep 1, 2015 |
| SSM Health St. Mary'S Hospital-Centralia |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Sep 1, 2015 |
| SSM Health St. Mary'S Hospital - Centralia |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Sep 1, 2015 |
| SSM Health Good Samaritan Hospital - Mt Vernon |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Sep 1, 2015 |
| SSM Health Medical Group |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2008 |
| SSM Health Medical Group Family Medicine |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Nov 16, 2014 |
| SSM Health Medical Group Family Medicine |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Dec 22, 1999 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070118000135 | MO | Part B Supplier - Clinic/Group Practice | 8921917352 |
Receives reassigned benefits from 18 practitioners Practice locations: Jefferson City, MO |
National Provider Directory
- Part of
- St Marys Holts Summit Phar
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
2511 W Edgewood Dr
Suite D
Jefferson City, MO 65109-5869
Mailing address
7655 Solutions Ctr
Chicago, IL 60677-7006
Phone (557) 203-1551
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 508364403 | Medicaid | MO |
Other names
- SSM Health Urgent Care
Other providers in Jefferson City, MO
- SSM Regional Health Services
- SSM Regional Health Services
- SSM Regional Health Services
- SSM Regional Health Services
- SSM Regional Health Services
- SSM Regional Health Services
- SSM Regional Health Services
- SSM Regional Health Services
- St Barnabas Reconciliation Ministries
- St. Joseph'S Bluffs Nursing and Rehab LLC
All providers in Jefferson City, MO · Urgent Care Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.