SSM AUDRAIN HEALTH CARE, INC (NPI# 1043660566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043660566 |
| Entity Type | Organization |
| Organization Name | SSM AUDRAIN HEALTH CARE, INC |
| Other Organization Name | SSM HEALTH MEDICAL GROUP |
| Practice Address |
515 E Promenade St Mexico MO 65265-2966 |
| Mailing Address |
Po Box 478 Mexico MO 65265-0010 |
| Practice Telephone | 5735828506 |
| Practice Fax Number | 5735823750 |
| Mailing Telephone | 5735818127 |
| Mailing Fax Number | 5738527053 |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2020-09-02 |
| Authorized Official Name | GARRICK MUELLER (CFO) |
| Authorized Official Telephone | 4022807582 |
| Is Organization Subpart | Y |
| Parent Organization Name | SSM AUDRAIN HEALTH CARE, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| SSM HEALTH MEDICAL GROUP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750763348 | Ssm Audrain Health Care, Inc | Clinic/Center | 350 Country Meadow Ln, Fulton, MO 65251 | 2015-06-19 |
| 1053826727 | Ssm Audrain Health Care, Inc | Clinic/Center | 620 E Monroe St, Mexico, MO 65265-2919 | 2017-12-04 |
| 1457712903 | Ssm Audrain Health Care, Inc | Psychiatry & Neurology | 620 E Monroe St, Mexico, MO 65265-2919 | 2016-03-11 |
| 1316320104 | Ssm Audrain Health Care, Inc | Orthopaedic Surgery | 515 E Promenade St, Mexico, MO 65265-2966 | 2015-06-30 |
| 1518340306 | Ssm Audrain Health Care, Inc | Clinic/Center | 3626 S Clark St, Mexico, MO 65265-4104 | 2015-06-30 |
| 1841334836 | Ssm Audrain Health Care, Inc | General Acute Care Hospital | 620 E Monroe St, Mexico, MO 65265-2919 | 2007-02-16 |
| 1952390122 | Ssm Audrain Health Care, Inc | General Acute Care Hospital | 620 E Monroe St, Mexico, MO 65265-2919 | 2005-10-19 |
| Street Address |
515 E PROMENADE ST |
| City | MEXICO |
| State | MO |
| Zip Code | 65265-2966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770536856 | Richard A White | Orthopaedic Surgery | 515 E Promenade St, Mexico, MO 65265-2966 | 2006-05-18 |
| 1316320104 | Ssm Audrain Health Care, Inc | Orthopaedic Surgery | 515 E Promenade St, Mexico, MO 65265-2966 | 2015-06-30 |
| 1083886972 | Missouri Ear Nose and Throat Center | Otolaryngology | 515 E Promenade St, Mexico, MO 65265-2966 | 2008-03-31 |
| 1871761437 | Heartland Ent Head and Neck Surgery, LLC | Otolaryngology | 515 E Promenade St, Mexico, MO 65265-2966 | 2008-02-18 |
| 1770504219 | Carrie A Lucas | Nurse Practitioner | 515 E Promenade St, Mexico, MO 65265-2966 | 2006-07-21 |
| 1801840442 | Ben L Jolly | Orthopaedic Surgery | 515 E Promenade St, Mexico, MO 65265-2966 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700448685 | Joanna Zidick Mcclarey | Specialist/Technologist | Rehabilitation Services, 711 E Jackson, Mexico, MO 65265 | 2019-07-01 |
| 1053858050 | Glenna Wilson | Social Worker | 2462 Southern Hls, Mexico, MO 65265 | 2017-01-27 |
| 1457601759 | Bruce Warren Garrett | Dentist | 626 Summit, Mexico, MO 65265 | 2012-09-13 |
| 1063775997 | Brandon Jay Glasgow | Physical Therapist | 2759 A S Clark, Mexico, MO 65265 | 2012-06-15 |
| 1407044548 | Missouri Central Physical Therapy, LLC | Specialist | 2759 A South Clark, Mexico, MO 65265 | 2007-10-12 |
| 1194925628 | Curators of The University of Missouri | Orthopaedic Surgery | 515 East Promenade, Mexico, MO 65265 | 2007-07-23 |
| 1740496199 | Scott Simmons | Family Medicine | 1000 Webster Street, Mexico, MO 65265 | 2007-05-15 |
| 1083741664 | Finck & Associates, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17079 Audrain County Road 929, Mexico, MO 65265 | 2007-02-28 |
| 1417005893 | Matthew Eugene Hart | Emergency Medicine | 620 E Monroe Street, Mexico, MO 65265 | 2007-01-08 |
| 1144392051 | Corrine M Floyd | Massage Therapist | 713 East Jackson, Mexico, MO 65265 | 2006-11-15 |
| Find all providers in zip 65265 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225123268 | Curators of The University of Missouri | Clinic/Center | 515 E Promenade, Mexico, MO 65265 | 2006-10-04 |
| 1053826727 | Ssm Audrain Health Care, Inc | Clinic/Center | 620 E Monroe St, Mexico, MO 65265-2919 | 2017-12-04 |
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| 1619513215 | Southeast Missouri Health Network | Clinic/Center | 835 W Murray Ln, Sikeston, MO 63801-4056 | 2019-11-19 |
| 1275014953 | Arch Pediatrics LLC | Clinic/Center | 3844 S Lindbergh Blvd Ste 216, Saint Louis, MO 63127-1369 | 2018-08-22 |
| 1174015515 | Washington University Physicians In Illinois, Inc | Clinic/Center | 4511 Forest Park Ave, Saint Louis, MO 63108-2138 | 2018-06-01 |
| 1164921300 | Texas County Memorial Hospital | Clinic/Center | 1333 S Sam Houston Blvd Ste A, Houston, MO 65483 | 2018-02-02 |
| 1053822650 | Edge Medical Services Inc. | Clinic/Center | 105 W 34th St Apt 2, Kansas City, MO 64111-1677 | 2017-10-23 |
| 1932618394 | United Physicians Group, LLC | Clinic/Center | 14825 N Outer 40 Rd Ste 365, Chesterfield, MO 63017-2152 | 2017-09-28 |
| 1073022000 | Fairview Heights Medical Group Sc | Clinic/Center | 670 Mason Ridge Center Dr Ste 300, Saint Louis, MO 63141-8573 | 2017-09-21 |
| 1013433762 | Elevating Care Clinic, LLC | Clinic/Center | 2340 E. Meyer Blvd, 208, Kansas City, MO 64132-1105 | 2017-08-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.