Jeffrey A Atkins, M.D.
Individual provider Active NPI Family Medicine Physician · Saint Peters, MO
NPI 1962496695 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1962496695
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- R3L25 (MO)
- Practice address
- 107 Piper Hill Dr Ste 100
Saint Peters, MO 63376-1651 - Phone
- (636) 447-4149
- NPI assigned
- Sep 8, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R3L25 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Hospital South | Past | Accepting new patients |
Interoperability endpoints
- jatkins291126@directc.mercy.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R3L25 | MO | Yes |
Addresses
Primary practice location
107 Piper Hill Dr Ste 100
Saint Peters, MO 63376-1651
Mailing address
107 Piper Hill Dr Ste 100
Saint Peters, MO 63376-1651
Phone (636) 447-4149
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202823704 | Medicaid | MO | |
| 1962496695 | Medicaid | MO |
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All providers in Saint Peters, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.