| Ssm Health Medical Group - Family Medicine | |
|
2511 W Edgewood Dr Ste G Jefferson City MO 65109-5869 | |
| (573) 761-0458 | |
| (573) 634-3137 |
| Full Name | Ssm Health Medical Group - Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 2511 W Edgewood Dr Ste G, Jefferson City, Missouri |
| Authorized Official Name and Position | Garrick Elliott Mueller (CFO) |
| Authorized Official Contact | 4052807582 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ssm Health Medical Group - Family Medicine Po Box 1027 Jefferson City MO 65102-1027 Ph: (573) 681-3767 | Ssm Health Medical Group - Family Medicine 2511 W Edgewood Dr Ste G Jefferson City MO 65109-5869 Ph: (573) 761-0458 |
| NPI Number | 1396886065 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 09/15/2020 |
| Medicare PECOS PAC ID | 8921917352 |
|---|---|
| Medicare Enrollment ID | O20070316000022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396886065 | NPI | - | NPPES |
| 507008803 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Matthew M Fiori |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164519963 PECOS PAC ID: 3476505538 Enrollment ID: I20050420000311 |
| Provider Name | Dennis M Knapik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336147602 PECOS PAC ID: 5698785301 Enrollment ID: I20060426000118 |
| Provider Name | Garry D Pearson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629011812 PECOS PAC ID: 3274630629 Enrollment ID: I20070518000210 |
| Provider Name | Jeffrey L Piontek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477595684 PECOS PAC ID: 0244337558 Enrollment ID: I20070522000304 |
| Provider Name | Julie A Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023448172 PECOS PAC ID: 8022249895 Enrollment ID: I20140319001145 |
| Provider Name | Treesa R Riedel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295140432 PECOS PAC ID: 9537384136 Enrollment ID: I20140715000275 |
| Provider Name | Christopher A Paynter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760749428 PECOS PAC ID: 1153634795 Enrollment ID: I20150724011839 |
| Provider Name | Ginger E Protzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104376326 PECOS PAC ID: 9234418005 Enrollment ID: I20161118000335 |
| Provider Name | Joanna L Younker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114278124 PECOS PAC ID: 1254648025 Enrollment ID: I20170928000503 |
| Provider Name | Dayna Lynette Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306349261 PECOS PAC ID: 6204184799 Enrollment ID: I20180731001302 |
| Provider Name | Renee Jean Scherr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386104818 PECOS PAC ID: 4587075296 Enrollment ID: I20201202001306 |
| Provider Name | Phillip Plotz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992753842 PECOS PAC ID: 5395762660 Enrollment ID: I20220616001063 |
| Provider Name | Laura Oberholz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396110490 PECOS PAC ID: 8224403639 Enrollment ID: I20230417000431 |
| Provider Name | Whitney N Bahner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326735481 PECOS PAC ID: 7012372659 Enrollment ID: I20230503002277 |
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Ssm Health Wound Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2505 Mission Dr, Suite 210, Jefferson City, MO 65109 Phone: 573-681-3000 Fax: 573-659-2503 | |
Innovative Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3218 W Edgewood Dr, Ste 500, Jefferson City, MO 65109 Phone: 949-696-6157 | |
Capital Region Physicians - Family Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 E High St, Jefferson City, MO 65101 Phone: 573-635-0916 Fax: 573-635-8812 | |
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