Jefferson Medical Group
NPI 1215030713ActiveOrganization· Family Medicine· Carrollton, MO
Family Medicine in Carrollton, Missouri, registered in NPPES in September 2006. The authorized official on file is Amy Danielle Ireland, Cfo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1215030713 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 7, 2006 |
| Last updated in NPPES | Oct 29, 2021 |
| Certified by provider | Oct 29, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Clinic/Center, Rural Health | 261QR1300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MO) |
|---|
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