Jennifer Anne Barclay, MD
Individual provider Active NPI Pediatrics Physician · Rolla, MO
NPI 1831556455 · NPPES record last updated Sep 7, 2023
Key facts
- NPI
- 1831556455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 2023005457 (MO)
- Practice address
- 1605 Martin Springs Dr Ste 250
Rolla, MO 65401-2980 - Phone
- (573) 458-6363
- NPI assigned
- Jan 27, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230810000413 | MO | Practitioner - Pediatric Medicine | 6709179781 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023005457 | MO | MD | Pediatrics Physician |
| R4000 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Current |
Accepting new patients | |
| Mercy Clinic Springfield Communities | Current |
Accepting new patients | |
| Mercy Clinic Springfield Communities | Current |
Accepting new patients |
Locations
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
1605 Martin Springs Dr
Ste 250
Rolla, MO 65401
Phone (573) 458-6363
3231 S National Ave
Ste 130
Springfield, MO 65807
Phone (417) 888-5665
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R4000 | TX | |
| Pediatrics Physician | 208000000X | 2023005457 | MO | Yes |
Addresses
Primary practice location
1605 Martin Springs Dr Ste 250
Rolla, MO 65401-2980
Mailing address
1605 Martin Springs Dr Ste 250
Rolla, MO 65401-2980
Phone (573) 458-6363
Other practice location 1
527 Gott Rd Bldg 810
Enid, OK 73705-5103
Phone (580) 213-6507
Other providers in Rolla, MO
- Ryan James Ballard
- Steven R Ballard
- Mahmoud Ballout
- Tasha Baney
- Amanda Christine Banks
- Jacqueline Lee Barlow
- Jamie Janece Barlow
- William Mark Barnett
- Caitlyn Micah Barry
- Bartle Chiropractic LLC
All providers in Rolla, MO · Pediatrics Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2023. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.