SSM AUDRAIN HEALTH CARE, INC. (NPI# 1336350214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336350214 |
| Entity Type | Organization |
| Organization Name | SSM AUDRAIN HEALTH CARE, INC. |
| Other Organization Name | SSM HEALTH MEDICAL GROUP- PEDIATRICS |
| Practice Address |
3626 S Clark St Suite A Mexico MO 65265-4104 |
| Mailing Address |
1001 Southwest Blvd Ste A Jefferson City MO 65109-2501 |
| Practice Telephone | 5735817366 |
| Practice Fax Number | 5735817422 |
| Mailing Telephone | 5736813000 |
| Mailing Fax Number | 5737616947 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2018-09-17 |
| Authorized Official Name | JAMES T STRATTON (REGIONAL CFO) |
| Authorized Official Telephone | 5736813129 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SSM Health Medical Group- Pediatrics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801225982 | Ssm Audrain Health Care, Inc. | Clinic/Center | 201 S. Main, Auxvasse, MO 65231 | 2013-11-08 |
| 1255340246 | Ssm Audrain Health Care, Inc. | Family Medicine | 1223 Main Street, Perry, MO 63462 | 2006-08-07 |
| 1356712871 | Ssm Audrain Health Care, Inc. | Psychiatric Unit | 620 E Monroe St, Mexico, MO 65265-2919 | 2015-10-09 |
| 1336576008 | Ssm Audrain Health Care, Inc. | Obstetrics & Gynecology | 605 E Promenade St, Suite A, Mexico, MO 65265-2926 | 2013-09-26 |
| 1548520026 | Ssm Audrain Health Care, Inc. | Family Medicine | 221 N Main St, Paris, MO 65275-1328 | 2012-05-18 |
| 1790838316 | Ssm Audrain Health Care, Inc. | Family Medicine | 3626 S Clark St, Mexico, MO 65265-4104 | 2007-01-18 |
| 1457469637 | Ssm Audrain Health Care, Inc. | Pediatrics | 3626 S Clark St Ste A, Mexico, MO 65265-4104 | 2006-08-28 |
| 1477563625 | Ssm Audrain Health Care, Inc. | Family Medicine | 625 E Summit St, Mexico, MO 65265-3294 | 2006-08-09 |
| 1871503466 | Ssm Audrain Health Care, Inc. | Internal Medicine | 600 Medical Park Dr, Mexico, MO 65265-3724 | 2006-08-08 |
| 1467462010 | Ssm Audrain Health Care, Inc. | Family Medicine | 626 E Summit St Ste L, Mexico, MO 65265-3298 | 2006-08-08 |
| Street Address |
3626 S CLARK ST SUITE A |
| City | MEXICO |
| State | MO |
| Zip Code | 65265-4104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801890256 | Ahmad H Muraywid | Pediatrics | 3626 S Clark St, Suite A, Mexico, MO 65265-4104 | 2005-06-13 |
| 1518340306 | Ssm Audrain Health Care, Inc | Clinic/Center | 3626 S Clark St, Mexico, MO 65265-4104 | 2015-06-30 |
| 1558757468 | Dawn Schuette | Nurse Practitioner | 3626 S Clark St, Suite C, Mexico, MO 65265-4104 | 2015-04-08 |
| 1457695330 | Kayla Ann Payton | Nurse Practitioner | 3626 S Clark St, Suite A, Mexico, MO 65265-4104 | 2012-11-16 |
| 1790838316 | Ssm Audrain Health Care, Inc. | Family Medicine | 3626 S Clark St, Mexico, MO 65265-4104 | 2007-01-18 |
| 1114942273 | Simon Mckeown | Family Medicine | 3626 S Clark St, Mexico, MO 65265-4104 | 2006-07-12 |
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801890256 | Ahmad H Muraywid | Pediatrics | 3626 S Clark St, Suite A, Mexico, MO 65265-4104 | 2005-06-13 |
| 1457469637 | Ssm Audrain Health Care, Inc. | Pediatrics | 3626 S Clark St Ste A, Mexico, MO 65265-4104 | 2006-08-28 |
| 1164407946 | Nancy J Bunge | Pediatrics | 340 Kelley Pkwy, Mexico, MO 65265-3811 | 2005-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114537222 | Natalie Joan Wilson | Pediatrics | 1463 Us Hwy 61, Suite C, Festus, MO 63028-6302 | 2020-08-04 |
| 1538786413 | Melissa An | Pediatrics | 1 Childrens Pl Ste 3s36, Saint Louis, MO 63110-1002 | 2020-06-26 |
| 1033731500 | Jessica N Zeiss | Pediatrics | 981 Highway K, Rhineland, MO 65069-2214 | 2020-05-07 |
| 1538795547 | Virtualnicu | Pediatrics | 10 Warridge Dr, Saint Louis, MO 63124-1166 | 2020-03-21 |
| 1811528656 | Children's Mercy-cockerell and Mcintosh Pediatrics, Inc | Pediatrics | 205 Nw R D Mize Rd Ste 304, Blue Springs, MO 64014-2520 | 2020-01-30 |
| 1134780430 | Jane Reardon | Pediatrics | 8140 Ward Pkwy Ste 275, Kansas City, MO 64114-2032 | 2019-06-26 |
| 1174082887 | Kristen Steinmeyer | Pediatrics | 714 Peace Haven Ct, Saint Louis, MO 63125-5404 | 2019-03-13 |
| 1023574365 | Saint Francis Medical Center | Pediatrics | 2210 Barron Rd Ste 120, Poplar Bluff, MO 63901-1908 | 2019-02-12 |
| 1215402011 | Ayse Bahar Budan Caliskan | Pediatrics | Washington University, St. Louis Children's Hospital, One Children's Place, 4n1, St. Louis, MO 63110-1002 | 2018-10-08 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SSM AUDRAIN HEALTH CARE, INC..
| 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.