SSM AUDRAIN HEALTH CARE, INC. (NPI# 1942219266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942219266 |
| Entity Type | Organization |
| Organization Name | SSM AUDRAIN HEALTH CARE, INC. |
| Other Organization Name | SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE |
| Practice Address |
111 W Bates St Wellsville MO 63384-1616 |
| Mailing Address |
Po Box 478 Mexico MO 65265-0010 |
| Practice Telephone | 5736842208 |
| Practice Fax Number | 5736843277 |
| Mailing Telephone | 5735818127 |
| Mailing Fax Number | 5738527053 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-09-02 |
| Authorized Official Name | GARRICK ELLIOTT MUELLER (CFO) |
| Authorized Official Telephone | 4052807582 |
| Is Organization Subpart | Y |
| Parent Organization Name | SSM AUDRAIN HEALTH CARE, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 592597207 | 05 |
| Other Name | Type Code |
|---|---|
| SSM Health Medical Group - Family Medicine | 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 |
| 1336350214 | Ssm Audrain Health Care, Inc. | Family Medicine | 3626 S Clark St, Suite A, Mexico, MO 65265-4104 | 2007-05-24 |
| 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 |
| Street Address |
111 W BATES ST |
| City | WELLSVILLE |
| State | MO |
| Zip Code | 63384-1616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336124023 | Eric F. Kondro | Internal Medicine | 111 W Bates St, Wellsville, MO 63384-1616 | 2005-12-14 |
| 1942510102 | Carolyn Sue Canterbury | Nurse Practitioner | 111 W Bates St, Wellsville, MO 63384-1616 | 2010-10-20 |
| 1669598710 | Cathy A. Hartle | Nurse Practitioner | 111 W Bates St, Wellsville, MO 63384-1616 | 2007-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821262478 | School District R 1 | Physical Therapist | 900 Burlington St, Wellsville, MO 63384-1114 | 2008-04-15 |
| 1598716029 | Ggnsc Wellsville LLC | Skilled Nursing Facility | 250 E Locust St, Wellsville, MO 63384-1422 | 2006-05-12 |
| 1487109633 | N & R of Wellsville LLC | Skilled Nursing Facility | 250 E Locust St, Wellsville, MO 63384-1422 | 2016-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245844992 | Sadie R Cole | Registered Nurse | 4220 Route 417 West, Wellsville, NY 14895 | 2020-09-01 |
| 1295370211 | Jennifer Lynn Mays | Registered Nurse | 40173 State Route 39, Wellsville, OH 43968-9782 | 2019-11-13 |
| 1376102558 | Theresa L. Golish | Home Health Aide | 125 South Broad St., Wellsville, NY 14895 | 2019-06-11 |
| 1144885138 | Melissa A Deming | Registered Nurse | 287 State Route 19, Wellsville, NY 14895-9452 | 2019-05-06 |
| 1396309605 | Janet Elane King | Registered Nurse | 11 Crescent Dr, Wellsville, NY 14895-9471 | 2019-04-23 |
| 1922662253 | Linda Lou Saunders | Registered Nurse | 1760 Covel Rd, Wellsville, NY 14895-9666 | 2019-04-22 |
| 1063979201 | Payton Munoz | Specialist/Technologist | 1783 Campground Rd, Wellsville, OH 43968-1721 | 2019-02-25 |
| 1154806578 | Angela Jones | Registered Nurse | 29 N Brooklyn Ave, Wellsville, NY 14895-1357 | 2018-10-02 |
| 1124504980 | Karen Leigh Overdorf | Nursing Care | 3358 State Route 19 N, Wellsville, NY 14895-9542 | 2018-07-16 |
| 1003392986 | Danielle Vantilburg | Home Health | 541 1/2 Main St, Wellsville, OH 43968-1653 | 2018-07-13 |
| Find all providers in WELLSVILLE | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467075622 | The Memorial Hospital of William F and Gertrude F Jones | Clinic/Center | 127 N Main St, Wellsville, NY 14895-1149 | 2020-05-22 |
| 1376166652 | The Memorial Hospital of William F and Gertrude F Jones | Clinic/Center | 15 Loder St, Wellsville, NY 14895-1112 | 2020-05-21 |
| 1043773591 | Adventhealth Ransom Memorial, Inc. | Clinic/Center | 424 Main St, Wellsville, KS 66092-8878 | 2019-04-11 |
| 1053704734 | Ransom Memorial Hospital | Clinic/Center | 424 Main St, Wellsville, KS 66092-8878 | 2015-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102137 | Washington County Memorial Hospital | Clinic/Center | 14206 Hwy C, Belgrade, MO 63622 | 2020-07-23 |
| 1891325072 | Scotland County Memorial Hospital | Clinic/Center | 55682 State Highway 6 Ste A, Edina, MO 63537-4268 | 2020-01-16 |
| 1639736457 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 800 Us Highway 61, New Madrid, MO 63869-1106 | 2019-05-28 |
| 1134633456 | Pike County Memorial Hospital | Clinic/Center | 1420 S Business 61 Unit Fde, Bowling Green, MO 63334-5230 | 2017-11-22 |
| 1720505894 | Perry County Health System | Clinic/Center | 210 Hospital Ln Ste 202, Perryville, MO 63775-4200 | 2017-08-29 |
| 1427572007 | Missouri Delta Medical Center | Clinic/Center | 209 W Yoakum Ave, Chaffee, MO 63740-1138 | 2017-07-26 |
| 1790213676 | Jackson Primary Care LLC | Clinic/Center | 2685 E Main St Ste A, Jackson, MO 63755-2474 | 2017-05-23 |
| 1972050581 | Sgoh Acquisition, Inc. | Clinic/Center | 912b State Highway 59, Goodman, MO 64843-8252 | 2016-09-01 |
| 1144605312 | Nevada City Hospital | Clinic/Center | 627 S Ash St Ste B, Nevada, MO 64772 | 2015-07-29 |
| 1669856829 | Ssm Regional Health Services | Clinic/Center | 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 | 2015-07-16 |
| Find all providers with the same taxonomy | ||||
| City | WELLSVILLE |
| Zip Code | 63384 |
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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.