Clarence William Jaggard Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2017039470 Issued in MO

Practice address

Ozark Valley Medical Clinic 5571 N. 21St St.
Ozark, MO 65721

Phone

(417) 317-5330

Fax

(417) 763-3370

NPI assigned

Mar 14, 2018

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Ozark Valley Medical Clinic, LLC

  • Family Medicine Physician
  • Ozark, MO
  • NPI 1639686850
  NPD (past)

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1932602125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5571 NORTH 21ST ST.",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "65721",
            "telephone_number": "417-317-5330",
            "fax_number": "417-763-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OZARK VALLEY MEDICAL CLINIC 5571 N. 21ST ST.",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "65721",
            "telephone_number": "417-317-5330",
            "fax_number": "417-763-3370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Lift Up Springfield 2005 E. Kearney St. Suite A",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "65803",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAGGARD",
        "first_name": "CLARENCE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2017039470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "0202204519",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE NUMBER",
            "identifier": "T61723021",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSISTANT PHYSICIAN LICENSE",
            "identifier": "2017039470",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kalob Cory Ihler, DMD
• Amber Nicole Iseman, DC
• Andrew Thomas Jackson, M.D.
• Brent Armstrong Jackson, MS
• Jennifer Jackson
• Jeanne James, FNP-BC
• Denise Jameson, D.C.
• Angela Jenkins
• Jessica Jo Jewell, WHNP
• JLM Professional Services LLC (JLMP Services)

• Family Medicine Physician in Ozark, MO
• Providers in Ozark, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.