MR. JESSE AARON CHAMPAGNE NPI 1114368511

NPI Information

  • NPI: 1114368511
  • Provider Name: MR. JESSE AARON CHAMPAGNE
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 900 W NIFONG BLVD
    STE 101
    COLUMBIA, MO
    ZIP 65203
  • Phone: (573) 815-6631

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NPI Details

MR. Jesse Aaron Champagne is a family nurse practitioner in Columbia, MO. MR. Jesse Aaron Champagne NPI is 1114368511. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

900 W NIFONG BLVD
STE 101
COLUMBIA, MO
ZIP 65203-467
Phone: (573) 815-6631
Fax: (573) 815-6634

The NPI 1114368511 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/13/2013 and was last updated on 5/3/2016.

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
1363LF0000XNurse PractitionerFamilyAP07350LOUISIANANo
2363LF0000XNurse PractitionerFamily2016004506MISSOURIYes

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: 11/21/2025

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