Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1184600181 Deactivated / Inactive NPI Male Practitioner

Jeffrey Kenneth Blue , PA

Physician Assistant • Licking, MO

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jeffrey Blue has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 21, 2005
NPI Deactivation Date August 05, 2020
Total Practice Duration ~15 Years of Practice (2005 – 2020)

Professional Overview & Biography Verified Profile Summary

Jeffrey Blue, PA was a registered Physician Assistant practicing in Licking, MO. Throughout an active medical career spanning 15 years, Jeffrey Blue provided care at the practice location at 233 S MAIN STREET until profile deactivation on 2020-08-05.

Historical Medicare Part B clinical services included established patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

233 S Main Street

Licking, MO 655420047

Telephone 5736743011
Fax 5736744765
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Licking, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.0 Yrs
State Avg: 10.3 Yrs
Regional Practice Density
2 Specialists

Practicing in Licking, MO (1802 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
52.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2017)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
71 59 $94.00 $41.77
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
13 13 $127.00 $64.31

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License MO 2002025629

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Whitney Hall , PA-C

Physician Assistant

NPI 1124437330

Physician Assistant (Certified)

Dr. Joshua Wolfe , MD

Family Medicine

NPI 1316262280

Doctor of Medicine (M.D.)

Emily Wiseman , FNP

Nurse Practitioner - Family

NPI 1700327897

Family Nurse Practitioner

NPI 1952980419

Doctor of Osteopathic Medicine (D.O.), Master of Public Health

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated August 05, 2020

Record deactivated on August 05, 2020

NPI Profile Active July 26, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location July 26, 2013

Registered at 233 S MAIN STREET, LICKING, MO 655420047 (Tel: 5736743011)

📍
Updated Business Mailing Address July 26, 2013

Registered at PO BOX 47, LICKING, MO 655420047 (Tel: 5736743011)

👤
Provider Name / Credentials Updated July 26, 2013

Recorded as JEFFREY BLUE, P. A.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 26, 2013

Physician Assistant (License #2002025629 in MO)

🟢
Initial NPI Registration & Enumeration December 21, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Jeffrey Blue. Be the first to share your experience!

Sign in to leave a review for Jeffrey Blue

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1184600181
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 21, 2005
Last Update: July 26, 2013
Deactivation Date: August 05, 2020

Mailing Address

Po Box 47

Licking, MO 655420047

Phone: 5736743011

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.