DR. JACK M DODSON M.D.
NPI 1821069345
Family Medicine in Jefferson City, MO

Q: What is Jack Dodson's NPI number?

The NPI number for Jack Dodson is 1821069345. It was assigned to this individual provider in the NPPES registry on February 1, 2006.

Q: What is Jack Dodson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jack Dodson was last updated on August 14, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since February 01, 2006PECOS Enrolled

1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109(573) 635-5264(573) 634-7423 Get Directions Write a Review

NPPES record last updated: August 14, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. Jack M Dodson M.d. NPPES

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

DR. JACK M DODSON M.D. (NPI 1821069345) is an individual family medicine provider in Jefferson City, Missouri, licensed in Missouri (101346) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821069345

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. JACK M DODSONCredential: M.D.

Location Address1241 W STADIUM BLVDJefferson City, MO 65109-6023

Mailing AddressPo Box 104240Jefferson City, MO 65110-4240 · (573) 635-5264 · Fax (573) 636-5881

Phone(573) 635-5264

Fax(573) 634-7423

Sole ProprietorNo

Enumeration DateFebruary 1, 2006

Last NPPES UpdateAugust 14, 2015

✔ NPI 1821069345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MO · 101346

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.

1241 W STADIUM BLVD, Jefferson City, MO 65109

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Other Identifiers 3

Medicare PIN001012662MO

Medicaid203375613MO

Medicare UPINF28506

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jack M Dodson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Jack Dodson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Jefferson City Medical Group, P.C.

1.1 mi

Multi-Specialty

1241 W STADIUM BLVD, FIRST FLOOR, SUITE 1100
Jefferson City, MO 65109

Reassigned Medicare billing, Missouri enrollment
Medicare enrollment name: Jefferson City Medical Group PC
155 clinicians in this Medicare group

NPI 1336189398 (573) 556-5747

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

5 suppliers12 claims26 services$6.07 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

2 suppliers13 claims13 services$37.58 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

3 suppliers12 claims12 services$87.08 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

3 suppliers18 claims51 services$35.03 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

3 suppliers11 claims11 services$48.96 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

3 suppliers15 claims15 services$17.14 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

DR. THOMAS W. SCHNEIDER M.D.

Internal Medicine (Pulmonary Disease)