JACKSON PRIMARY CARE LLC
NPI 1619961380
Family Medicine in Jackson, MO

Q: What is Jackson Primary Care LLC's NPI number?

The NPI number for Jackson Primary Care LLC is 1619961380. It was assigned to this organization in the NPPES registry on September 8, 2005.

Q: What is Jackson Primary Care LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since September 08, 2005CLIA 26D0984553 · Microscopy

2685 E MAIN ST SUITE A, STE A, JACKSON, MO 63755(573) 204-1400(573) 204-1480 Get Directions Write a Review

NPPES record last updated: October 26, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jackson Primary Care Llc NPPES

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

JACKSON PRIMARY CARE LLC (NPI 1619961380) is a healthcare organization registered as a family medicine in Jackson, Missouri and active in the NPI registry since September 2005. The organization holds a CLIA Microscopy certificate valid through June 11, 2027 and lists Deanna M Siemer, Owner, as its authorized official.

NPPES Registry Identity

NPI1619961380

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameJACKSON PRIMARY CARE LLC

Location Address2685 E MAIN ST SUITE A, STE AJackson, MO 63755

Mailing Address2685 E Main St Suite A, Ste AJackson, MO 63755 · (573) 204-1400 · Fax (573) 204-1480

Phone(573) 204-1400

Fax(573) 204-1480

Organization SubpartNo

Authorized OfficialDeanna M SiemerOwner · (573) 204-1400

Enumeration DateSeptember 8, 2005

Last NPPES UpdateOctober 26, 2010

✔ NPI 1619961380 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedObstetrics & GynecologyTaxonomy 207V00000X

Also ListedClinic/Center · Rural HealthTaxonomy 261QR1300X

2685 E MAIN ST SUITE A, Jackson, MO 63755

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Other Identifiers 3

Other132588MO · Bcbs

Medicaid509303004MO

Medicare ID-Type Unspecified000013775MO

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 26D0984553

Jackson Primary Care LLC · Jackson, MO

Active · expires Jun 11, 2027

CLIA Number26D0984553

Laboratory TypePhysician Office

Certificate Effective DateJune 12, 2025

Certificate Expiration DateJune 11, 2027

Laboratory DirectorDeanna M. Siemer MD

Laboratory Phone(573) 204-1400

Laboratory LocationJackson Primary Care LLC2685 East Main, Ste A, Jackson, MO 63755

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Jackson Primary Care LLC's NPI number?

The NPI number for Jackson Primary Care LLC is 1619961380. It was assigned to this organization in the NPPES registry on September 8, 2005.

Where is Jackson Primary Care LLC located?

Jackson Primary Care LLC is located at 2685 E Main St Suite A Ste A, Jackson, MO 63755. The listed phone number is (573) 204-1400.

What is Jackson Primary Care LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Jackson Primary Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 26D0984553) is associated with this NPI, valid through June 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Jackson Primary Care LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 3 other insurers list Jackson Primary Care LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jackson Primary Care LLC was last updated on October 26, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years 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.