NPIMap

Individual provider Active NPI

Joseph Charles Rakestraw, D.O.

  • Family Medicine Physician
  • Jefferson City, MO
National Provider Identifier
1922002864
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
106237 Issued in MO
Practice address
1500 Southwest Blvd Ste D
Jefferson City, MO 65109-2472
Phone
(573) 635-6350
Fax
(573) 635-9049
NPI assigned
Jun 9, 2005
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 106237 MO Primary

Addresses

Primary practice location

1500 Southwest Blvd Ste D
Jefferson City, MO 65109-2472

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Other identifiers 2

IdentifierTypeStateIssuer
248012114MedicaidMO
248012122MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100603000921 MO Practitioner - Family Practice 4880694116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1125 Madison St
Jefferson City, MO 65101-5227
Phone (573) 635-7141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
The Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
St. Joseph's Bluffs Nursing and Rehab LLC Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

1125 Madison St
Jefferson Cty, MO 65101
Phone (573) 632-5000

1500 Southwest Blvd
Ste B
Jefferson Cty, MO 65109
Phone (573) 635-1577

1500 Southwest Blvd
Ste D
Jefferson Cty, MO 65109
Phone (573) 632-5780

2041 Silva Ln
Moberly, MO 65270
Phone (660) 263-1894

901 Kidwell Dr
Versailles, MO 65084
Phone (573) 378-4666

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1922002864",
    "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": "573-882-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SOUTHWEST BLVD STE D",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092472",
            "telephone_number": "573-635-6350",
            "fax_number": "573-635-9049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKESTRAW",
        "first_name": "JOSEPH",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "106237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "248012114",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "248012122",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.