POPLAR BLUFF REGIONAL MEDICAL CENTER LLC (NPI# 1174550115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174550115 |
| Entity Type | Organization |
| Organization Name | POPLAR BLUFF REGIONAL MEDICAL CENTER LLC |
| Other Organization Name | BLOOMFIELD MEDICAL CLINIC |
| Practice Address |
101 S. Prairie Bloomfield MO 63825-0200 |
| Mailing Address |
Po Box 200 101 S. Praire Bloomfield MO 63825-0200 |
| Practice Telephone | 5735683838 |
| Mailing Telephone | 5735683838 |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2018-02-07 |
| Authorized Official Name | PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL) |
| Authorized Official Telephone | 6159254565 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 598557007 | 05 |
| Other Name | Type Code |
|---|---|
| Bloomfield Medical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972549053 | Poplar Bluff Regional Medical Center LLC | Clinic/Center | #1 Hal's Plaza, Piedmont, MO 63957 | 2006-06-20 |
| 1700821212 | Poplar Bluff Regional Medical Center LLC | Clinic/Center | 610 N One Mile Rd, Dexter, MO 63841-2539 | 2006-06-18 |
| 1275576654 | Poplar Bluff Regional Medical Center LLC | Clinic/Center | 130 E Harbin Ave, Puxico, MO 63960-9104 | 2006-06-14 |
| 1801839147 | Poplar Bluff Regional Medical Center LLC | Clinic/Center | 806 N Douglass St, Malden, MO 63863-1512 | 2006-06-14 |
| 1700831724 | Poplar Bluff Regional Medical Center LLC | Psychiatric Unit | 3100 Oak Grove Rd., Poplar Bluff, MO 63901 | 2006-05-24 |
| 1558985911 | Poplar Bluff Regional Medical Center LLC | Medicare Defined Swing Bed Unit | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2020-06-02 |
| 1730330168 | Poplar Bluff Regional Medical Center LLC | Nurse Anesthetist, Certified Registered | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2008-10-03 |
| 1962446054 | Poplar Bluff Regional Medical Center LLC | General Acute Care Hospital | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2006-06-16 |
| Street Address |
101 S. PRAIRIE |
| City | BLOOMFIELD |
| State | MO |
| Zip Code | 63825-0200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902951429 | Regina Lewis | Nurse Practitioner | 101 S. Prairie, Bloomfield, MO 63825 | 2007-01-24 |
| 1558395103 | Dick J Newell | Family Medicine | 101 S. Prairie, Bloomfield, MO 63825 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073039715 | Susan L Shea | Counselor | 402 Barbara Street, Bloomfield, MO 63825 | 2017-08-15 |
| 1750571931 | Robin Denise Osborn | Counselor | 206 S Prairie Street, Bloomfield, MO 63825 | 2007-07-25 |
| 1265575385 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 1003 State Hwy 25 North, Bloomfield, MO 63825 | 2007-02-15 |
| 1588714992 | Bloomfield R-14 Schools | Local Education Agency (LEA) | 505 Court St., Bloomfield, MO 63825 | 2007-01-11 |
| 1326108226 | Dexter Hospital LLC | Internal Medicine | 1003 Highway 25 North, Bloomfield, MO 63825 | 2006-12-11 |
| 1245317700 | Amy Holland | Nurse Practitioner | 1003 Hwy 25 N, Bloomfield, MO 63825 | 2006-11-01 |
| 1225112345 | Town Pharmacy Inc. | Pharmacy | 700 Highway 25 South, Bloomfield, MO 63825 | 2006-10-25 |
| 1114015682 | Cecil Ray Vincent Sr. | Pharmacist | 302 S Prairie, Bloomfield, MO 63825 | 2006-10-10 |
| 1033182092 | Peter W Somers | Family Medicine | 101 South Prairie Street, Bloomfield, MO 63825 | 2006-02-09 |
| 1023424041 | Poplar Bluff Regional Medical Center, LLC | Family Medicine | 101 South Prairie Street, Bloomfield, MO 63825 | 2014-07-10 |
| Find all providers in zip 63825 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265575385 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 1003 State Hwy 25 North, Bloomfield, MO 63825 | 2007-02-15 |
| 1699753285 | Greene County Health Clinic, LLC | Clinic/Center | 12 W Main St, Bloomfield, IN 47424-1424 | 2006-01-04 |
| 1821413667 | Davis County Hospital | Clinic/Center | 509 N Madison St, Ste 100, Bloomfield, IA 52537-1271 | 2014-03-04 |
| 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 | BLOOMFIELD |
| Zip Code | 63825 |
Please comment or provide details below to improve the information on POPLAR BLUFF REGIONAL MEDICAL CENTER LLC.
| 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.