SOUTHEAST HEALTH CENTER OF REYNOLDS COUNTY, LLC (NPI# 1437575198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437575198 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST HEALTH CENTER OF REYNOLDS COUNTY, LLC |
| Other Organization Name | SOUTHEASTHEALTH FAMILY MEDICINE OF ELLINGTON |
| Practice Address |
350 E Walnut St Ellington MO 63638-7943 |
| Mailing Address |
100 Highway 21 N Ellington MO 63638-9409 |
| Practice Telephone | 5736632571 |
| Practice Fax Number | 5736632779 |
| Mailing Telephone | 5736632511 |
| Mailing Fax Number | 5736632815 |
| Enumeration Date | 2014-03-05 |
| Last Update Date | 2014-03-05 |
| Authorized Official Name | PAULA E HARRIS (VICE PRESIDENT REGIONAL OPERATIONS) |
| Authorized Official Telephone | 5737780020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| SoutheastHEALTH Family Medicine of Ellington | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750706453 | Southeast Health Center of Reynolds County, LLC | Clinic/Center | 1009 Business Hwy 60, Van Buren, MO 63965-9103 | 2014-03-04 |
| 1285050948 | Southeast Health Center of Reynolds County, LLC | Clinic/Center | 100 Highway 21 N, Ellington, MO 63638-9409 | 2014-03-05 |
| Street Address |
350 E WALNUT ST |
| City | ELLINGTON |
| State | MO |
| Zip Code | 63638-7943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437152303 | Paul De Vries Rains | Family Medicine | 350 E Walnut St, Ellington, MO 63638-7943 | 2005-05-24 |
| 1871559245 | Advanced Health Care Management Services, LLC | Home Health | 350 E Walnut St, Ste 1, Ellington, MO 63638-8098 | 2006-04-25 |
| 1912962291 | Susan L Byerley | Nurse Practitioner | 350 E Walnut St, Ellington, MO 63638-7943 | 2006-04-19 |
| 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 | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285050948 | Southeast Health Center of Reynolds County, LLC | Clinic/Center | 100 Highway 21 N, Ellington, MO 63638-9409 | 2014-03-05 |
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|---|---|---|---|---|
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| 1114483468 | Your Optimal Healthcare LLC | Clinic/Center | 300 W 4th St Ste H, Eureka, MO 63025-1839 | 2019-02-12 |
| 1306313051 | Country Care Family Clinic, LLC | Clinic/Center | 3 E Cleveland Ave, Ellsinore, MO 63937 | 2018-10-31 |
| 1285118950 | Vera Whole Health, Wa PC | Clinic/Center | 8350 N. Church Road, Kansas City, MO 64158 | 2018-09-19 |
| 1003324542 | Quad/med, LLC | Clinic/Center | 2015 Ne Jefferson Street, Grain Valley, MO 64029 | 2018-01-18 |
| 1093267601 | Careatc-saint Peter | Clinic/Center | 4601 Executive Centre Pkwy, Saint Peters, MO 63376-1683 | 2016-10-30 |
| 1407303480 | Kerns Family Health Care LLC | Clinic/Center | 1335 Vilage Dr B, St. Joseph, MO 64506-2457 | 2016-09-07 |
| 1316491020 | Wecare Tlc - Wwt Mo Family Health Center | Clinic/Center | 58 Weldon Pkwy, Bldg 58, Maryland Heights, MO 63043-3237 | 2016-08-10 |
| 1255703500 | Community Hospital Association | Clinic/Center | 101 South Washington Street, Oregon, MO 64473 | 2015-10-27 |
| 1023485752 | Dennis E. Robinson D.o. | Clinic/Center | 487 Pomme De Terre Dr., Marshfield, MO 65706 | 2015-08-28 |
| 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.