NPIMap

Organization Active NPI

Capital Region Medical Center

Doing business as Capital Region Physicians - Capital Family Care

  • Family Medicine Physician
  • Jefferson City, MO
National Provider Identifier
1942358866
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CAPITAL REGION MEDICAL CENTER
Doing business as
Capital Region Physicians - Capital Family Care
Practice address
1500 Southwest Blvd
Suite B
Jefferson City, MO 65109-2472
Phone
(573) 635-6350
Fax
(573) 635-9049
NPI assigned
Jan 8, 2007
Last updated
Aug 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Authorized official

Name
Tom Luebbering
Title
VP of Finance
Phone
(573) 632-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1500 Southwest Blvd
Suite B
Jefferson City, MO 65109-2472

Mailing address

1500 Southwest Blvd
Suite B
Jefferson City, MO 65109-2472
Phone (573) 635-6350

Other identifiers 1

IdentifierTypeStateIssuer
206009703MedicaidMO

Other names 1

  • Capital Region Physicians - Capital Family Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Capital Region Medical Center47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

Locations

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377216000000",
    "number": "1942358866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 SOUTHWEST BLVD",
            "address_2": "SUITE B",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092472",
            "telephone_number": "573-635-6350",
            "fax_number": "573-635-9049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SOUTHWEST BLVD",
            "address_2": "SUITE B",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092472",
            "telephone_number": "573-635-6350",
            "fax_number": "573-635-9049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL REGION MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2013-08-23",
        "status": "A",
        "authorized_official_last_name": "LUEBBERING",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "573-632-5100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206009703",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital Region Physicians - Capital Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; 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.