Jared Louis Atwood, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6221 Issued in OK

Practice address

1000 W Nifong Blvd
Building 4, Suite 100
Columbia, MO 65203

Phone

(573) 443-0466

Fax

(573) 442-5417

NPI assigned

Jun 28, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2014 through Jul 1, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Columbia Oral & Maxillofacial Surgery LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Columbia, MO
  • NPI 1770591752
  NPD (past)
• Columbia Oral and Maxillofacial Services, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Columbia, MO
  • NPI 1447736715
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1891006557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W NIFONG BLVD",
            "address_2": "BUILDING 4, SUITE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65203",
            "telephone_number": "573-443-0466",
            "fax_number": "573-442-5417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W NIFONG BLVD",
            "address_2": "BUILDING 4, SUITE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65203",
            "telephone_number": "573-443-0466",
            "fax_number": "573-442-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWOOD",
        "first_name": "JARED",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-28",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "6221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Atkinson
• Kelly Ann Atkinson, NP-C
• Atlas Autism Health Missouri LLC
• Atoz Transports LLC
• Jeanine Rachael Atwell, M.S.
• Matthew Thomas Atwood
• Daniel Michael Au, M.D.
• Mallory Jo Aughtman, LMSW
• Urvaksh Avanthsa, DO
• Christa Ann Avenell, CRNA

• Oral and Maxillofacial Surgery (Dentist) in Columbia, MO
• Providers in Columbia, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.

Verify at the official NPI Registry.