CAPITAL REGION MEDICAL CENTER NPI 1629031018

NPI Information

NPI: 1629031018
Provider Name: CAPITAL REGION MEDICAL CENTER

Doing Business As: CAPITAL REGION PHYSICIANS - PEDIATRIC ASSOCIATES

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
1014 MADISON ST
JEFFERSON CITY, MO
ZIP 65102
Phone: (573) 632-5525
Get Directions

CAPITAL REGION MEDICAL CENTER is a multi-specialty clinic center in Jefferson City, MO. CAPITAL REGION MEDICAL CENTER NPI is 1629031018. The provider is registered as an organization entity type.
The provider Is Doing Business As Capital Region Physicians - Pediatric Associates.

The provider's business location address is:

1014 MADISON ST
JEFFERSON CITY, MO
ZIP 65102-458
Phone: (573) 632-5525
Fax: (573) 632-5811

The provider's authorized official is Tom Luebbering .
The authorized official title is Vp Of Finance and has the following contact phone number (573) 632-5100.

The enumeration date for this NPI number is 4/8/2006 and was last updated on 8/23/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty	41910	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	507515500	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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