Active NPI
Jeffrey C. Harden, D.O.
- Psychiatry Physician
- Kirksville, MO
National Provider Identifier
1962471037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- R6D63
- Practice address
- 1 Crown Dr
Suite 104
Kirksville, MO 63501-2510 - Phone
- (660) 665-7500
- Fax
- (660) 665-7546
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | R6D63 | MO | Primary |
Addresses
Primary practice location
1 Crown Dr
Suite 104
Kirksville, MO 63501-2510
Mailing address
1 Crown Dr
Suite 104
Kirksville, MO 63501-2510
Phone (660) 665-7500
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000005781 | Other | MO | GATEWAY EDI |
| 431554537-63501 | Other | MO | CHAMPUS |
| 242657500 | Medicaid | MO | |
| BLUE CROSS/BLUE SHIE | Other | MO | 13044 |
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective Jan 1, 2011 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R6D63 | MO | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357776000000",
"number": "1962471037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CROWN DR",
"address_2": "SUITE 104",
"city": "KIRKSVILLE",
"state": "MO",
"postal_code": "635012510",
"telephone_number": "660-665-7500",
"fax_number": "660-665-7546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CROWN DR",
"address_2": "SUITE 104",
"city": "KIRKSVILLE",
"state": "MO",
"postal_code": "635012510",
"telephone_number": "660-665-7500",
"fax_number": "660-665-7546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARDEN",
"first_name": "JEFFREY",
"middle_name": "C.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2013-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "R6D63",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY EDI",
"identifier": "000005781",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "431554537-63501",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "242657500",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "13044",
"identifier": "BLUE CROSS/BLUE SHIE",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kirksville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.