Active NPI
Sidney George Christiansen, MD
- Otolaryngology Physician
- Columbia, MO
National Provider Identifier
1942264551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- R8683
- Practice address
- 812 Keene St
Columbia, MO 65201-6633 - Phone
- (573) 817-3000
- Fax
- (573) 876-6950
- NPI assigned
- Apr 12, 2006
- Last updated
- Jun 9, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | R8683 | MO | Primary |
Addresses
Primary practice location
812 Keene St
Columbia, MO 65201-6633
Mailing address
PO Box 7687
Columbia, MO 65205-7687
Phone (573) 817-3000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 156282 | Other | MO | BLUE SHIELD |
| 201090024 | Medicaid | MO | |
| 156282 | Other | MO | BLUE CHOICE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R8683 | MO | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307577600000",
"number": "1942264551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7687",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652057687",
"telephone_number": "573-817-3000",
"fax_number": "573-876-6950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 KEENE ST",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652016633",
"telephone_number": "573-817-3000",
"fax_number": "573-876-6950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTIANSEN",
"first_name": "SIDNEY",
"middle_name": "GEORGE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-12",
"last_updated": "2011-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MO",
"license": "R8683",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "156282",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201090024",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "156282",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
- Roseanna Marie Christal Arand, AUD
- Sarah C Christenberry, MD
- Alice Christensen, PH.D.
- Angela Marie Christiansen, PT
- Dustin Christiansen, MD
- Mack Alan Christianson
- Christina E. Stixrud & Associates, M.D., P.C.
- Christine Woods, LLC (Crowned Counseling with Dr. Christine Woods)
- Shelby Nicole Christy
- Asa Sebastian Chu, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.