ADVANCED HEALTH CARE MANAGEMENT SERVICES, LLC (NPI# 1285690644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285690644 |
| Entity Type | Organization |
| Organization Name | ADVANCED HEALTH CARE MANAGEMENT SERVICES, LLC |
| Other Organization Name | ADVANCED HEALTHCARE MEDICAL CENTER |
| Practice Address |
100 Highway 21 N Ellington MO 63638-9409 |
| Mailing Address |
Po Box 989 Poplar Bluff MO 63902-0989 |
| Practice Telephone | 5736632511 |
| Practice Fax Number | 5736632815 |
| Mailing Telephone | 5737780020 |
| Mailing Fax Number | 5737767548 |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2013-07-30 |
| NPI Deactivation Date | 02/06/2013 |
| NPI Reactivation Date | 2013-07-30 |
| Authorized Official Name | PAULA E. HARRIS (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5737780020 |
| Is Organization Subpart | Y |
| Parent Organization Name | ADVANCED HEALTH CARE MANAGEMENT SERVICES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
459-5 | MO | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 010323707 | 05 |
| Other Name | Type Code |
|---|---|
| Advanced Healthcare Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871559245 | Advanced Health Care Management Services, LLC | Home Health | 350 E Walnut St, Ste 1, Ellington, MO 63638-8098 | 2006-04-25 |
| 1306802632 | Advanced Health Care Management Services, LLC | Clinic/Center | 2002 Kanell Blvd, Poplar Bluff, MO 63901-4045 | 2006-04-25 |
| Street Address |
100 HIGHWAY 21 N |
| City | ELLINGTON |
| State | MO |
| Zip Code | 63638-9409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861861726 | Southeast Health Center of Reynolds LLC | Medicare Defined Swing Bed Unit | 100 Highway 21 N, Ellington, MO 63638-9409 | 2015-09-22 |
| 1265843148 | Meramec Emergency Physicians, LLP | Hospitalist | 100 Highway 21 N, Ellington, MO 63638-9409 | 2014-05-14 |
| 1285050948 | Southeast Health Center of Reynolds County, LLC | Clinic/Center | 100 Highway 21 N, Ellington, MO 63638-9409 | 2014-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831398858 | Linda Lee Potter | Counselor | 125 A Temple St, Ellington, MO 63638 | 2007-07-11 |
| 1942424254 | Iris Fae Ross | Counselor | 110 N. Second St., Ellington, MO 63638 | 2007-04-11 |
| 1700916400 | Southern Reynolds Rii | Speech-Language Pathologist | One School Street, Ellington, MO 63638 | 2007-03-06 |
| 1467533604 | Sherilyn K Clark | Registered Nurse | 110 S. 2nd St., Ellington, MO 63638 | 2006-10-17 |
| 1770678211 | Big Springs Medical Association | Clinic/Center | 115 Walnut St, Ellington, MO 63638 | 2006-10-03 |
| 1376637728 | Jeanie Larue Mcclanahan | Dental Assistant | 115 Walnut St., Ellington, MO 63638 | 2006-10-02 |
| 1730450156 | Tasha Lynn Wisdom | Social Worker | 315 E Walnut St, Ellington, MO 63638 | 2012-01-17 |
| 1033420039 | Meagan Whitley Berry | Dental Hygienist | 115 Walnut St, Ellington, MO 63638 | 2010-06-24 |
| 1689814329 | Healthpro Physical Therapy LLC | Clinic/Center | 315 East Walnut, Ellington, MO 63638 | 2009-02-20 |
| 1992984173 | Dr. Stephen C. Waller, Dds, LLC | Dentist | 115 Walnut St, Ellington, MO 63638 | 2007-10-24 |
| Find all providers in zip 63638 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356689905 | Southeast Health Center of Reynolds County LLC | General Acute Care Hospital | 100 Hwy 21, Ellington, MO 63638-7943 | 2013-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467789222 | Va Medical Center In St.louis | General Acute Care Hospital | 9830 Eastdell Dr, Saint Louis, MO 63136-1915 | 2009-11-14 |
| 1750512042 | Vicky Laurine Simbro | General Acute Care Hospital | 4505 Cove Rd, Osage Beach, MO 65065-2307 | 2009-08-04 |
| 1710177480 | Wisam Hassan Ali Al Badr | General Acute Care Hospital | 3635 Grand Blvd, Saint Louis, MO 63110-2539 | 2007-07-30 |
| 1619179561 | Saint Louis University Medical Center | General Acute Care Hospital | 1402 S Grand Blvd # M238, Saint Louis, MO 63104-1004 | 2007-06-04 |
| 1962578609 | Hermann Area Hospital District | General Acute Care Hospital | 509 West 18th St, Hermann, MO 65041 | 2006-11-27 |
| 1477648178 | Iron County Hospital District | General Acute Care Hospital | 301 N Highway 21, Pilot Knob, MO 63663-0548 | 2006-10-04 |
| 1023053477 | Mercy St. Francis Hospital | General Acute Care Hospital | 100 West Highway 60, Mountain View, MO 65548 | 2006-06-19 |
| 1912948308 | Saint Lukes Hospital of Chillicothe | General Acute Care Hospital | 2799 N Washington, Chillicothe, MO 64601-2902 | 2006-06-09 |
| 1720039605 | Cedar County Memorial Hospital | General Acute Care Hospital | 1401 S Park St, El Dorado Springs, MO 64744-2037 | 2006-05-15 |
| 1841274057 | Saint Luke's Hospital of Trenton | General Acute Care Hospital | 191 Iowa Blvd, Trenton, MO 64683-8343 | 2005-12-01 |
| 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.