SOUTHEAST MISSOURI HEALTH NETWORK (NPI# 1497035661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497035661 |
Entity Type | Organization |
Organization Name | SOUTHEAST MISSOURI HEALTH NETWORK |
Other Organization Name | BENTON MEDICAL CENTER |
Practice Address |
6724 State Highway 77 Benton MO 63736-8238 |
Mailing Address |
6738 State Highway 77 Benton MO 63736-8238 |
Practice Telephone | 5737487712 |
Practice Fax Number | 5735454425 |
Mailing Telephone | 5733132500 |
Mailing Fax Number | 5733132505 |
Enumeration Date | 2011-08-19 |
Last Update Date | 2020-04-14 |
Authorized Official Name | SARA DEANE (CHIEF FINANCIAL OFFICER) |
Authorized Official Telephone | 5733132500 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 509509303 | 05 |
Other Name | Type Code |
---|---|
benton dental center | Doing Business As Name - Organization |
Benton Medical Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619513215 | Southeast Missouri Health Network | Clinic/Center | 835 W Murray Ln, Sikeston, MO 63801-4056 | 2019-11-19 |
1790257228 | Southeast Missouri Health Network | Physician Assistant | Kennett Middle School Clinic, 510 College Ave, Kennett, MO 63857-2062 | 2018-12-21 |
1679019491 | Southeast Missouri Health Network | Dentist | 111 Prairie Drive, East Prairie, MO 63845 | 2017-01-18 |
1649697566 | Southeast Missouri Health Network | Clinic/Center | Caruthersville Medical Center, 109 East 5th Street, Caruthersville, MO 63830-1417 | 2014-03-28 |
1528348778 | Southeast Missouri Health Network | Dentist | 6724 Highway 77 E, Benton, MO 63736 | 2011-08-19 |
1598069247 | Southeast Missouri Health Network | Dentist | 420 Semo Dr, New Madrid, MO 63869-1734 | 2011-01-10 |
1194945154 | Southeast Missouri Health Network | Clinic/Center | 741 S Walnut St, Bernie, MO 63822-8900 | 2007-05-01 |
1720209794 | Southeast Missouri Health Network | Clinic/Center | 700 N Douglass St, Malden, MO 63863-1510 | 2007-05-01 |
1609095975 | Southeast Missouri Health Network | Clinic/Center | 421 Semo Dr, New Madrid, MO 63869-1733 | 2007-04-25 |
1932108974 | Southeast Missouri Health Network | Clinic/Center | 6738 State Highway 77, Benton, MO 63736-8238 | 2005-07-20 |
Street Address |
6724 STATE HIGHWAY 77 |
City | BENTON |
State | MO |
Zip Code | 63736-8238 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699084814 | Travis James Weiss | Physician Assistant | 6724 State Highway 77, Benton, MO 63736-8238 | 2010-10-05 |
1992048961 | Jessica Pickel | Dental Hygienist | 6724 State Highway 77, Benton, MO 63736-8238 | 2013-03-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528348778 | Southeast Missouri Health Network | Dentist | 6724 Highway 77 E, Benton, MO 63736 | 2011-08-19 |
1245415389 | Comprehensive Family Health Care LLC | Family Medicine | 142 S Winchester St, Benton, MO 63736-0000 | 2008-01-08 |
1427385376 | Amber Nicole Thorne | Nurse Practitioner | 6468 State Highway 77, Benton, MO 63736-8237 | 2009-11-13 |
1609230507 | Missouri Delta Medical Center | Clinic/Center | 6468 State Highway 77, Benton, MO 63736-8237 | 2016-04-07 |
1902297880 | Jaimie Suzanne Cannon | Nurse Practitioner | 6468 State Highway 77, Benton, MO 63736-8237 | 2015-02-12 |
1932108974 | Southeast Missouri Health Network | Clinic/Center | 6738 State Highway 77, Benton, MO 63736-8238 | 2005-07-20 |
1366514523 | Scott County R-iv School District | Physical Therapist | 4035 State Highway 77, Benton, MO 63736-9162 | 2006-11-14 |
1407489727 | Lana Jean Atkins | Speech-Language Pathologist | 4035 State Highway 77, Benton, MO 63736-9162 | 2020-02-14 |
1043686546 | A & A In-home Health Care, LLC | Home Health | 568 County Highway 504, Benton, MO 63736-9193 | 2015-08-19 |
1275134264 | Stephanie Suzanne Worth | Physical Therapy Assistant | 135 Meyers Lake Ct, Benton, MO 63736-9201 | 2020-11-05 |
Find all providers in zip 63736 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932108974 | Southeast Missouri Health Network | Clinic/Center | 6738 State Highway 77, Benton, MO 63736-8238 | 2005-07-20 |
1689168643 | Arcare | Clinic/Center | 630 W South St, Benton, AR 72015-4258 | 2018-06-21 |
1619181484 | Ocoee Regional Health Corporation | Clinic/Center | 6784 Highway 411, Benton, TN 37307-4818 | 2007-05-10 |
1386857381 | Ocoee Regional Health Corporation | Clinic/Center | 6784 Highway 411, Benton, TN 37307-0308 | 2007-05-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952909079 | Northwest Health Services Inc | Clinic/Center | 202 S East St, Albany, MO 64402-1836 | 2020-10-12 |
1912505041 | Northwest Health Services Inc | Clinic/Center | 10500 State Route T, Savannah, MO 64485-2456 | 2020-10-12 |
1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
1407478399 | Big Springs Medical Association | Clinic/Center | 2879 James Blvd, Poplar Bluff, MO 63901-3395 | 2020-05-13 |
1295356731 | Health Care Coalition of Lafayette County | Clinic/Center | 811 S Business Highway 13, Lexington, MO 64067-1515 | 2020-05-06 |
1376164699 | East Central Missouri Behavioral Health Services, Inc | Clinic/Center | 896 S Sturgeon St, Montgomery City, MO 63361-2716 | 2020-04-27 |
1750912044 | Northwest Health Services, Inc. | Clinic/Center | 418 E 2nd St, Maryville, MO 64468-1703 | 2020-01-27 |
1669003950 | Northwest Health Services, Inc. | Clinic/Center | 525 W South Hills Dr, Maryville, MO 64468-3653 | 2020-01-27 |
1063052553 | Compass Health, Inc. | Clinic/Center | 1319 E Highway 24 Ste B, Moberly, MO 65270-3682 | 2020-01-13 |
1407490741 | Advocates for A Healthy Community Inc | Clinic/Center | 2238 W Kingsley St, Springfield, MO 65807-5456 | 2019-10-30 |
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.