MERCY CLINIC EAST COMMUNITIES (NPI# 1235493776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235493776 |
| Entity Type | Organization |
| Organization Name | MERCY CLINIC EAST COMMUNITIES |
| Practice Address |
125 N Old Highway 66 Bourbon MO 65441-6298 |
| Practice Telephone | 5736792006 |
| Mailing Telephone | 5736792006 |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2014-05-08 |
| Authorized Official Name | JOHN W. HUBERT (PRESIDENT) |
| Authorized Official Telephone | 3142511560 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | MERCY HEALTH EAST COMMUNITIES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720635329 | Mercy Clinic East Communities | Family Medicine | 10004 Kennerly Rd Ste 395b, Saint Louis, MO 63128-2190 | 2019-08-20 |
| 1164857397 | Mercy Clinic East Communities | Clinic/Center | 16555 Manchester Rd Ste 110, Wildwood, MO 63040-1220 | 2013-09-06 |
| 1700370061 | Mercy Clinic East Communities | Internal Medicine | 15945 Clayton Rd Ste 310, Ballwin, MO 63011-2493 | 2018-06-20 |
| 1285998724 | Mercy Clinic East Communities | Clinic/Center | 301 Theresa St, Cuba, MO 65453-1636 | 2012-06-29 |
| 1467716928 | Mercy Clinic East Communities | Clinic/Center | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2012-06-29 |
| 1619231164 | Mercy Clinic East Communities | Clinic/Center | 520 Pine St, Steelville, MO 65565-6041 | 2012-06-29 |
| 1043574940 | Mercy Clinic East Communities | Allergy & Immunology | 615 S New Ballas Rd, Administration Building, 5th Floor, Saint Louis, MO 63141-8221 | 2012-06-26 |
| 1073739041 | Mercy Clinic East Communities | Family Medicine | 615 S New Ballas Rd, Administrative Building, 5th Floor, Saint Louis, MO 63141-8221 | 2007-04-18 |
| 1851335228 | Mercy Clinic East Communities | Family Medicine | 615 S New Ballas Rd, Administration Building, 5th Floor, Saint Louis, MO 63141-8221 | 2006-06-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MERCY CLINIC EAST COMMUNITIES | 645 Maryville Centre Dr, Saint Louis, MO 63141-5855 |
| Street Address |
125 N OLD HIGHWAY 66 |
| City | BOURBON |
| State | MO |
| Zip Code | 65441-6298 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528268737 | Mark Williams Heywood | Chiropractor | 522 E Pine St, Bourbon, MO 65441 | 2007-07-25 |
| 1356462949 | Sunshine Residential, LLC | Custodial Care Facility | 541 Rock Road, Bourbon, MO 65441 | 2007-04-02 |
| 1013018654 | Vivian Dudley | Nurse Practitioner | 125 N Old Hwy 66, Bourbon, MO 65441 | 2006-09-26 |
| 1124285309 | Lynn Marie Schmader | Dentist | 246 College, Bourbon, MO 65441-0129 | 2008-05-16 |
| 1508280645 | Clark's Rx Farmington LLC | Pharmacy | 194 N Old Highway 66 Unit A, Bourbon, MO 65441-6298 | 2014-02-10 |
| 1568597110 | Kathryn L Schlemper | Speech-Language Pathologist | 1444 S Old Highway 66, County of Crawford Public Schools Cons Dist R I, Bourbon, MO 65441-6300 | 2007-02-23 |
| 1306062161 | County of Crawford Public Schools | Physical Therapist | 1444 S Old Highway 66, Bourbon, MO 65441-6300 | 2007-04-18 |
| 1043609381 | Sunshine Rc LLC | Custodial Care Facility | 541 Rock Rd, Bourbon, MO 65441-6324 | 2015-01-09 |
| 1245746072 | Medley Pharmacy, Inc | Pharmacy | 124 Old Highway 66, Bourbon, MO 65441-6544 | 2017-12-15 |
| 1649391020 | Bourbon Drugs Inc | Pharmacy | 386 E Pine St, Bourbon, MO 65441-7506 | 2007-04-03 |
| Find all providers in zip 65441 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326131475 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 240 College St, Bourbon, MO 65441-8308 | 2006-10-02 |
| 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 | ||||
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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.