| Brandi Nichols, MD | |
|
1241 W Stadium Blvd, Jefferson City, MO 65109-6023 | |
| (573) 636-5248 | |
| (573) 636-9390 |
| Full Name | Brandi Nichols |
|---|---|
| Gender | Female |
| Speciality | Obstetrics/gynecology |
| Experience | 19 Years |
| Location | 1241 W Stadium Blvd, Jefferson City, Missouri |
| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578656674 | NPI | - | NPPES |
| 1578656674 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 2010017190 (Missouri) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Jefferson City Medical Group Pc | 1850371089 | 102 |
| Community Health Ctr Of Central Missouri | 2062456015 | 16 |
| Entity Name | Jefferson City Medical Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336189398 PECOS PAC ID: 1850371089 Enrollment ID: O20040908000924 |
| Entity Name | Community Health Ctr Of Central Missouri |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538213244 PECOS PAC ID: 2062456015 Enrollment ID: O20050610000717 |
| Mailing Address | Practice Location Address |
|---|---|
| Brandi Nichols, MD Po Box 104240, Jefferson City, MO 65110-4240 Ph: (573) 635-5264 | Brandi Nichols, MD 1241 W Stadium Blvd, Jefferson City, MO 65109-6023 Ph: (573) 636-5248 |
Amanda Taube Rodemann, DO Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1241 W Stadium Blvd, Suite 102, Jefferson City, MO 65109 Phone: 573-636-5248 Fax: 573-636-9390 | |
Dr. William H. Marshall, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 1241 W Stadium Blvd, Jefferson City, MO 65109 Phone: 573-635-5264 Fax: 573-556-5757 | |
Jodi A Berendzen, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1241 W Stadium Blvd, Suite 102, Jefferson City, MO 65109 Phone: 573-636-5248 Fax: 573-636-9390 | |
Teri A Deffenbaugh, DO Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1125 Madison St, Ob Gyn Associates, Jefferson City, MO 65101 Phone: 573-632-5510 Fax: 573-632-5810 | |
Serese Yvonne Smith-haxton, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1125 Madison St, Jefferson City, MO 65101 Phone: 573-632-5510 Fax: 573-632-5810 | |
Dana Madsen Calcutt, DO Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 1014 Madison St, Ob/gyn Associates, Jefferson City, MO 65101 Phone: 573-632-5510 Fax: 573-632-5810 |