Innovative Medical Clinic
NPI 1063290260 · Multi-Specialty Clinic/Center · Jefferson City, MO
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Innovative Medical Clinic is a Multi-Specialty Clinic/Center organization in Jefferson City, MO (NPI 1063290260).
Provider details
- NPI number
- 1063290260
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Elochukwu Osoego, Owner(949) 696-6157
Specialties & taxonomies
Ambulatory Health Care Facilities
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
- Urgent Care Clinic/Center261QU0200X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-09-19
- Last updated
- 2023-09-21
- Certified
- 2023-09-21
Frequently asked questions
- What is Innovative Medical Clinic's NPI number?
- Innovative Medical Clinic's National Provider Identifier (NPI) is 1063290260, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Innovative Medical Clinic?
- Innovative Medical Clinic is classified in the NPPES registry as Multi-Specialty Clinic/Center (Ambulatory Health Care Facilities).
- Where is Innovative Medical Clinic located?
- Innovative Medical Clinic's practice location on file with NPPES is 3218 W Edgewood Dr, Jefferson City, MO 65109.
- What is Innovative Medical Clinic's phone number?
- The practice phone number listed in the NPPES registry for Innovative Medical Clinic is (949) 696-6157.
- Does Innovative Medical Clinic accept Medicare?
- Innovative Medical Clinic is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Innovative Medical Clinic?
- The authorized official listed on Innovative Medical Clinic's NPPES record is Elochukwu Osoego, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Innovative Medical Clinic's NPI active?
- Yes — Innovative Medical Clinic's NPI (1063290260) is active in the NPPES registry as of the last update on 2023-09-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.