SOUTHEAST MISSOURI HEALTH NETWORK (NPI# 1780803916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780803916 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST MISSOURI HEALTH NETWORK |
| Other Organization Name | PORTAGEVILLE FAMILY CLINIC |
| Practice Address |
314 E Main St Portageville MO 63873-1616 |
| Mailing Address |
311 Main St P.o. Box 400 New Madrid MO 63869-1942 |
| Practice Telephone | 5733795929 |
| Practice Fax Number | 5733795912 |
| Mailing Telephone | 5737482404 |
| Mailing Fax Number | 5737488929 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2011-03-07 |
| Authorized Official Name | CHERYL A WHITE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5737482404 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHEAST MISSOURI HEALTH NETWORK |
| 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 | GROUP PTAN | 000010626 | 01 |
| MO | 503973901 | 05 |
| Other Name | Type Code |
|---|---|
| PORTAGEVILLE FAMILY CLINIC | 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 |
314 E MAIN ST |
| City | PORTAGEVILLE |
| State | MO |
| Zip Code | 63873-1616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194093526 | Health Facilities Rehab Services Inc | Clinic/Center | 314 E Main St, Portageville, MO 63873-1616 | 2011-12-13 |
| 1629115670 | Dennis Reed | Physician Assistant | 314 E Main St, Portageville, MO 63873-1616 | 2007-01-31 |
| 1699873372 | Pemiscot County Memorial Hospital | Clinic/Center | 314 E Main St, Portageville, MO 63873-1616 | 2006-09-20 |
| 1669589677 | Ralph Kelley | Family Medicine | 314 E Main St, Portageville, MO 63873-1616 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801158357 | Mindy Leigh French | Speech-Language Pathologist | 100 W 12th St, Portageville, MO 63873-1036 | 2012-06-11 |
| 1689299372 | Life Continues LLC | Community/Behavioral Health | 412 W 5th St, Portageville, MO 63873-1108 | 2020-06-09 |
| 1558574988 | Lee Kellams | Speech-Language Pathologist | 500 W 5th St, Portageville, MO 63873-1147 | 2007-05-08 |
| 1902910300 | Mary Samples | Speech-Language Pathologist | 904 King Ave, Portageville, MO 63873-1378 | 2006-08-19 |
| 1093858714 | Portageville School District | Local Education Agency (LEA) | 904 King Ave, Portageville, MO 63873-1378 | 2007-02-14 |
| 1871593905 | Lorna A Turnage | Clinic/Center | 203 E 3rd St, Portageville, MO 63873-1401 | 2005-07-29 |
| 1730622697 | Lorna Turnage | Family Medicine | 203 E 3rd St, Portageville, MO 63873-1401 | 2016-11-28 |
| 1841465671 | A Plus Family Clinic | Family Medicine | 203 E 3rd St, Portageville, MO 63873-1401 | 2008-04-23 |
| 1518968296 | Lorna Turnage | Family Medicine | 203 E 3rd St, Portageville, MO 63873-1401 | 2005-08-03 |
| 1053307975 | Andrew Ernest Painter | Family Medicine | 204 E 3rd St, Portageville, MO 63873-1402 | 2005-09-26 |
| Find all providers in zip 63873 | ||||
| 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 | PORTAGEVILLE |
| Zip Code | 63873 |
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.