SOUTHEAST MISSOURI HEALTH NETWORK (NPI# 1649697566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649697566 |
Entity Type | Organization |
Organization Name | SOUTHEAST MISSOURI HEALTH NETWORK |
Other Organization Name | CARUTHERSVILLE MEDICAL CENTER |
Practice Address |
Caruthersville Medical Center 109 East 5th Street Caruthersville MO 63830-1417 |
Mailing Address |
6738 State Highway 77 Benton MO 63736-8238 |
Practice Telephone | 5733599803 |
Practice Fax Number | 5733590990 |
Mailing Telephone | 5733132500 |
Mailing Fax Number | 5733132505 |
Enumeration Date | 2014-03-28 |
Last Update Date | 2019-05-22 |
Authorized Official Name | MS. SARAH 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 | 1649697566 | 05 |
Other Name | Type Code |
---|---|
Caruthersville Medical Center | Doing Business As Name - Organization |
hayti medical and dental clinic | Doing Business As Name - Organization |
Address | Telephone Number | Fax Number |
---|---|---|
223 S 3rd St, Hayti, MO 638511617 | 5733599803 | 5733590990 |
Caruthersville Medical Center, 109 East 5th Street, Caruthersville, MO 63830 | 5733599803 | 5733590990 |
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 |
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 |
1770129199 | Southeast Missouri Health Network | Clinic/Center | 200 Pine St, Sikeston, MO 63801-3258 | 2019-11-20 |
Street Address |
CARUTHERSVILLE MEDICAL CENTER 109 EAST 5TH STREET |
City | CARUTHERSVILLE |
State | MO |
Zip Code | 63830-1417 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689216400 | Jazmyne S Hall | Behavior Technician | 915 Highway 84, Caruthersville, MO 63830 | 2019-10-14 |
1134573017 | Nathan Straeter | Pharmacist | State Highway 84 West, Caruthersville, MO 63830 | 2016-04-18 |
1861805624 | Ashley Marie Ballard | Case Manager/Care Coordinator | 10 & Ward Suite C, Caruthersville, MO 63830 | 2014-06-09 |
1356764435 | Jena Payne | Case Manager/Care Coordinator | 10th Ward St, Caruthersville, MO 63830 | 2014-01-27 |
1619390705 | James Smith | Case Manager/Care Coordinator | 10th & Ward Suite B, Caruthersville, MO 63830 | 2014-01-27 |
1730501370 | Belinda Fields | Community Health Worker | 10th & Ward, C, Caruthersville, MO 63830 | 2014-01-16 |
1831387372 | T M Swinger & D V Mckillip, Ptr | Optometrist | 101 E. 10th St., Suite A, Caruthersville, MO 63830 | 2007-10-10 |
1437284635 | Terrence M Swinger | Optometrist | 101 E. Tenth St., Suite A, Caruthersville, MO 63830 | 2007-02-21 |
1114097581 | John D Gardner | Dentist | 1210 Ward Ave, Caruthersville, MO 63830 | 2006-11-09 |
1366512287 | Krilurk Chanvitayapongs | Pharmacist | 2709 South Ward, Caruthersville, MO 63830 | 2006-11-08 |
Find all providers in zip 63830 |
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 |
---|---|---|---|---|
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 |
City | CARUTHERSVILLE |
Zip Code | 63830 |
Please comment or provide details below to improve the information on SOUTHEAST MISSOURI HEALTH NETWORK.
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.