| Ssm Health Medical Group - Pediatrics | |
|
3348 American Ave Jefferson City MO 65109-1079 | |
| (573) 761-7210 | |
| (573) 634-8802 |
| Full Name | Ssm Health Medical Group - Pediatrics |
|---|---|
| Speciality | Clinic/Center |
| Location | 3348 American Ave, 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 - Pediatrics Po Box 1027 Jefferson City MO 65102-1027 Ph: (573) 681-3767 | Ssm Health Medical Group - Pediatrics 3348 American Ave Jefferson City MO 65109-1079 Ph: (573) 761-7210 |
| NPI Number | 1396782587 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 09/15/2020 |
| Medicare PECOS PAC ID | 8921917352 |
|---|---|
| Medicare Enrollment ID | O20040907000920 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396782587 | NPI | - | NPPES |
| 501283501 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Jennifer P Krause |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255361036 PECOS PAC ID: 5799756334 Enrollment ID: I20040805000539 |
| Provider Name | Brian Conley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093746653 PECOS PAC ID: 8820031404 Enrollment ID: I20050606000022 |
| Provider Name | Bridgett A Wekenborg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912258195 PECOS PAC ID: 0345495479 Enrollment ID: I20130221000254 |
| Provider Name | Olga Brea Pena |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417333253 PECOS PAC ID: 3173875226 Enrollment ID: I20181017003486 |
| Provider Name | Megan Marie Kruse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477274827 PECOS PAC ID: 5890166219 Enrollment ID: I20230123002741 |
| Provider Name | Hala Alsalhi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790246528 PECOS PAC ID: 1557744745 Enrollment ID: I20240517000668 |
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Capital Region Corporate Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Southwest Blvd, Ste C, Jefferson City, MO 65109 Phone: 573-632-5786 Fax: 573-632-5833 | |
Family Medicine Of Jefferson City, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1616 Southridge Dr, Suite #203, Jefferson City, MO 65109 Phone: 573-659-7300 Fax: 573-636-0555 | |
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 | |
Jefferson City Medical Group, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1735 Elm Ct, Jefferson City, MO 65101 Phone: 573-634-4878 |