CAPITAL REGION MEDICAL CENTER NPI 1124091285

NPI Information

  • NPI: 1124091285
  • Provider Name: CAPITAL REGION MEDICAL CENTER
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: CAPITAL REGION PHYSICIANS - SOUTHWEST
  • CLIA Number: 26D0446123
  • Address: 1500 SOUTHWEST BLVD
    STE D
    JEFFERSON CITY, MO
    ZIP 65109
  • Phone: (573) 632-5780

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NPI Details

CAPITAL REGION MEDICAL CENTER is a family medicine in Jefferson City, MO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CAPITAL REGION MEDICAL CENTER NPI is 1124091285. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Capital Region Physicians - Southwest.

The provider's business location address is:

1500 SOUTHWEST BLVD
STE D
JEFFERSON CITY, MO
ZIP 65109
Phone: (573) 632-5780
Fax: (573) 632-5833

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 CLIA number assigned to this NPI record is 26D0446123 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/9/2006 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
1363L00000XNurse PractitionerNo
2207Q00000XFamily MedicineYes

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
1000012091MEDICARE ID-TYPE UNSPECIFIEDMISSOURI
2502474406MEDICAIDMISSOURI
3CH7258OTHERMISSOURIRR MEDICARE

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: 3/30/2025

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