Jefferson Medical Group
Jefferson Medical Group is a healthcare organization registered as Family Medicine Physician in Carrollton, MO, holding Type 2 (organization) NPI 1215030713 since 2006. The authorized official on file is Amy Ireland, Cfo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1215030713 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Jefferson Medical Group |
| Practice address | 1502 N JEFFERSON ST, Carrollton, MO, 64633 |
| Phone | 6605429998 |
| Fax | 6605429880 |
| Enumeration date | 2006-09-07 |
| Last updated in NPPES | 2021-10-29 |
Authorized official
| Name | Amy Ireland |
|---|---|
| Title | Cfo |
| Phone | 6603296005 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QR1300X | Rural Health Clinic/Center | Secondary | — | — |
| 207Q00000X | Family Medicine Physician | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50899330 | Medicaid | MO | — |
Copy-ready billing details
Provider: Jefferson Medical Group NPI: 1215030713 Taxonomy: 207Q00000X (Family Medicine Physician) Address: 1502 N JEFFERSON ST, Carrollton, MO, 64633
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1205831013 | Carroll County Memorial Hospital | Organization | Home Health Agency | Carrollton, MO |
| 1932105673 | Gregory Hubbard | Individual | Orthopaedic Surgery Physician | Carrollton, MO |
| 1528067113 | Carroll County Memorial Hospital | Organization | Critical Access Hospital | Carrollton, MO |
| 1861451015 | Grazyna Dymek | Individual | Pediatrics Physician | Carrollton, MO |
| 1861448664 | Richard Smith | Individual | Family Medicine Physician | Carrollton, MO |
| 1942316708 | Carroll Cnty Mem Hosp Pharmacy Inc | Organization | Institutional Pharmacy | Carrollton, MO |
| 1811090780 | Timothy Reid | Individual | Family Medicine Physician | Carrollton, MO |
| 1982773586 | Tara Swan | Individual | Family Nurse Practitioner | Carrollton, MO |
Verify this record
Cross-check NPI 1215030713 against the authoritative CMS record: view Jefferson Medical Group on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
How current is this record?
Where is Jefferson Medical Group located?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2021-10-29.