Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

SSM Regional Health Services

Organization General Practice Physician · NPI 1043450711

SSM Regional Health Services provides General Practice Physician services in Jefferson City, Missouri. Registered with an NPI since 2009.

In the registry since
2009

Practice location Address checks out

2505 Mission Dr Ste 210
Jefferson City, MO 65109-9508
Phone: (573) 681-3000
Fax: (573) 659-2503
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1043450711
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSSM Regional Health Services
Authorized official Shasta Manuel — Regional Vice President Finance/Cfo · (405) 272-7282
Other names Ssm Health Wound Center; Ssm Health Wound Center
NPI enumeratedFebruary 20, 2009
Last updated in NPPESDecember 16, 2025
Certification dateDecember 16, 2025
Mailing address7655 Solutions Ctr, Chicago, IL 60677-7006

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