POPLAR BLUFF REGIONAL MEDICAL CENTER, LLC (NPI# 1225380108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225380108 |
| Entity Type | Organization |
| Organization Name | POPLAR BLUFF REGIONAL MEDICAL CENTER, LLC |
| Other Organization Name | POPLAR BLUFF PRIMARY CARE |
| Practice Address |
2360 Katy Ln Poplar Bluff MO 63901-2300 |
| Practice Telephone | 5737122546 |
| Practice Fax Number | 5737122549 |
| Mailing Telephone | 5737122546 |
| Mailing Fax Number | 5737122549 |
| Enumeration Date | 2012-10-03 |
| 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 | MEDICARE OSCAR | 268685 | 01 |
| Other Name | Type Code |
|---|---|
| Poplar Bluff Primary Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679989693 | Poplar Bluff Regional Medical Center, LLC | Family Medicine | 1 Hals Plz, Piedmont, MO 63957-1613 | 2014-07-10 |
| 1023424041 | Poplar Bluff Regional Medical Center, LLC | Family Medicine | 101 South Prairie Street, Bloomfield, MO 63825 | 2014-07-10 |
| 1841606860 | Poplar Bluff Regional Medical Center, LLC | Family Medicine | 806 N Douglass St, Malden, MO 63863-1512 | 2014-07-10 |
| 1760898787 | Poplar Bluff Regional Medical Center, LLC | Family Medicine | 2588 N Westwood Blvd, Poplar Bluff, MO 63901-2339 | 2014-07-10 |
| 1669888681 | Poplar Bluff Regional Medical Center, LLC | Family Medicine | 610 N One Mile Rd, Dexter, MO 63841-2539 | 2014-07-10 |
| 1932515954 | Poplar Bluff Regional Medical Center, LLC | Pediatrics | 2360 Katy Ln, Poplar Bluff, MO 63901-2300 | 2014-07-10 |
| 1750797775 | Poplar Bluff Regional Medical Center, LLC | Family Medicine | 130 E Harbin Ave, Puxico, MO 63960-9104 | 2014-07-10 |
| 1881965267 | Poplar Bluff Regional Medical Center, LLC | Clinic/Center | 2588 N Westwood Blvd, Poplar Bluff, MO 63901-2535 | 2012-01-18 |
| Street Address |
2360 KATY LN |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-2300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972564359 | Rubina A Mirza | Internal Medicine | 2360 Katy Ln, Poplar Bluff, MO 63901-2300 | 2006-03-28 |
| 1932515954 | Poplar Bluff Regional Medical Center, LLC | Pediatrics | 2360 Katy Ln, Poplar Bluff, MO 63901-2300 | 2014-07-10 |
| 1760742084 | David William Wood | Family Medicine | 2360 Katy Ln, Poplar Bluff, MO 63901-2300 | 2012-05-21 |
| 1710162722 | Brandi N Myers | Nurse Practitioner | 2360 Katy Ln, Poplar Bluff, MO 63901-2300 | 2008-01-08 |
| 1770638249 | Cheryl Rodery | Nurse Practitioner | 2360 Katy Ln, Poplar Bluff, MO 63901-2300 | 2007-01-24 |
| 1902836216 | Girish R Bhatt | Surgery | 2360 Katy Ln, Poplar Bluff, MO 63901-2300 | 2006-07-03 |
| 1689620635 | Gene Fioretti | Internal Medicine | 2360 Katy Ln, Poplar Bluff, MO 63901-2300 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275511859 | Kneibert Clinic LLC | Clinic/Center | 2588 N Westwood Blvd, Poplar Bluff, MO 63901 | 2006-01-04 |
| 1356849616 | Heartland Women's Healthcare Mo PC | Clinic/Center | 2340 Katy Ln, Poplar Bluff, MO 63901-2300 | 2018-01-31 |
| 1457881963 | Poplar Bluff Pediatric Assoc Ll | Clinic/Center | 2210 Barron Rd, Poplar Bluff, MO 63901-1908 | 2017-06-16 |
| 1508237926 | Family Counseling Center, Inc. | Clinic/Center | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2015-10-12 |
| 1780927871 | Southeast Health Center of Stoddard County, LLC | Clinic/Center | 2002 Kanell Blvd, Poplar Bluff, MO 63901-4045 | 2013-03-27 |
| 1881965267 | Poplar Bluff Regional Medical Center, LLC | Clinic/Center | 2588 N Westwood Blvd, Poplar Bluff, MO 63901-2535 | 2012-01-18 |
| 1376841064 | Black River Healthcare, Inc. | Clinic/Center | 1879 N Westwood Blvd, Poplar Bluff, MO 63901-2833 | 2011-03-04 |
| 1144451063 | Internal Medicine Associates of Southeast Missouri LLC | Clinic/Center | 225 Physicians Park, Poplar Bluff, MO 63901-3956 | 2009-07-28 |
| 1629208848 | Internal Medicine Associates of Southeast Missouri LLC | Clinic/Center | 223 Physicians Park, Poplar Bluff, MO 63901-3956 | 2009-07-22 |
| 1578517918 | Christopher R. Montgomery, Md | Clinic/Center | 2400 Lucy Lee Pkwy, Suite B, Poplar Bluff, MO 63901-2429 | 2006-05-20 |
| Find all providers in POPLAR BLUFF | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
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.