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JONATHAN LEE MINOR M.D.
NPI 1609195452
Pediatrics - Sports Medicine in Rolla, MO

Active since May 19, 2010PECOS EnrolledAccepts Medicare Assignment
910 W 10TH ST, ROLLA, MO 65409(573) 342-4284(573) 341-6967 Get Directions Write a Review

NPPES record last updated: March 30, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 30, 2026, Nov 11, 2020, Nov 11, 2015 (3 updates tracked since 2015).

About Jonathan Lee Minor M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONATHAN LEE MINOR M.D. (NPI 1609195452) is an individual sports medicine provider in Rolla, Missouri, licensed in California (A137057) and active in the NPI registry since May 2010. He is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1609195452
Entity TypeIndividualMale
Primary Taxonomy2080S0010X
Provider Legal NameJONATHAN LEE MINORCredential: M.D.
Location Address910 W 10TH STRolla, MO 65409-6519
Mailing Address910 W 10th StRolla, MO 65409-6519 · (573) 342-4284 · Fax (573) 341-6967
Phone(573) 342-4284
Fax(573) 341-6967
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateMay 19, 2010
Last NPPES UpdateMarch 30, 20263 updates tracked since enumeration
NPPES CertifiedMarch 30, 2026
✔ NPI 1609195452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080S0010X
License✔ Licensed in CA · A137057
Definition
A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Also ListedGeneral PracticeTaxonomy 208D00000X · License 2020036607 (MO)
910 W 10TH ST, Rolla, MO 65409
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Other Identifiers 1

OtherCB238713CA · Medicare Ptan

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jonathan Lee Minor M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133344807
PECOS Enrollment IDI20171127000785
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CASEY RHAE BALL FNP-BC
Nurse Practitioner (Family)
910 W 10TH ST
ROLLA, MO 65409
Phelps County (573) 341-4284
DR. ELIZABETH C DODD D.O.
Pediatrics
910 W 10TH ST
ROLLA, MO 65409
Phelps County (573) 341-4284
THE CURATORS OF THE UNIVERSITY OF MISSOURI
Clinic/Center (Student Health)
910 W 10TH ST
ROLLA, MO 65409
Phelps County (573) 341-4284
MELINDA BRYSON RN, FNP-C
Nurse Practitioner (Family)
910 W 10TH ST
ROLLA, MO 65409
Phelps County (573) 341-4284

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Minor's NPI number?

The NPI number for Jonathan Minor is 1609195452. It was assigned to this individual provider in the NPPES registry on May 19, 2010.

Where is Jonathan Minor located?

Jonathan Minor practices at 910 W 10th St, Rolla, MO 65409. The listed phone number is (573) 342-4284.

What is Jonathan Minor's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Sports Medicine, with taxonomy code 2080S0010X.

Is Jonathan Minor enrolled in Medicare?

Yes. Jonathan Minor is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jonathan Minor was last updated on March 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.