POPLAR BLUFF REGIONAL MEDICAL CENTER LLC (NPI# 1558985911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558985911 |
| Entity Type | Organization |
| Organization Name | POPLAR BLUFF REGIONAL MEDICAL CENTER LLC |
| Practice Address |
3100 Oak Grove Rd Poplar Bluff MO 63901-1573 |
| Practice Telephone | 5737762000 |
| Practice Fax Number | 5737769086 |
| Mailing Telephone | 5737762000 |
| Mailing Fax Number | 5737769086 |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2020-06-02 |
| Authorized Official Name | PAULA LALOR (DIRECTOR) |
| Authorized Official Telephone | 6159254565 |
| Is Organization Subpart | Y |
| Parent Organization Name | POPLAR BLUFF REGIONAL MEDICAL CENTER LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | Hospital Units |
| Other Name | Type Code |
|---|---|
| Poplar Bluff Regional Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174550115 | Poplar Bluff Regional Medical Center LLC | Clinic/Center | 101 S. Prairie, Bloomfield, MO 63825-0200 | 2006-06-26 |
| 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 |
| 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 |
3100 OAK GROVE RD |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-1573 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356305684 | Tirso J Aldana | Internal Medicine | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2006-04-13 |
| 1073133237 | Poplar Bluff Regional Medical Center | Clinical Medical Laboratory | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2020-04-17 |
| 1568946515 | Carol Lee Pratt | Nurse Practitioner | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2018-09-15 |
| 1457842163 | Rachel Matthews | Social Worker | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2018-05-29 |
| 1669995155 | Stacy Lee Taylor | Registered Nurse | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2017-07-17 |
| 1700314010 | Miranda Krishna | Nurse Practitioner | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2017-05-31 |
| 1689110611 | Prachi Avinash Pophali | Internal Medicine | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2017-01-14 |
| 1588118020 | Abhishek Ambarisha Bhandiwad | Internal Medicine | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2016-08-13 |
| 1982056545 | Butler Physician Services, LLC | Pediatrics | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2016-07-07 |
| 1720445463 | Theresa Louise Pennington | Nurse Practitioner | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2016-01-26 |
| Find all providers in the same location | ||||
| 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 | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013054212 | Ste Genevieve County Memorial Hospital | Medicare Defined Swing Bed Unit | 800 Sainte Genevieve Dr, Ste Genevieve, MO 63670-1434 | 2007-01-30 |
| 1104801547 | Barton County Memorial Hospital | Medicare Defined Swing Bed Unit | 29 Nw 1st Ln, Lamar, MO 64759-8105 | 2005-12-08 |
| 1245220052 | Ray County Memorial Hospital | Medicare Defined Swing Bed Unit | 904 Wollard Blvd, Richmond, MO 64085-2229 | 2005-10-24 |
| 1083601330 | Western Missouri Medical Center | Medicare Defined Swing Bed Unit | 403 Burkarth Rd, Warrensburg, MO 64093 | 2005-10-03 |
| 1407469778 | Noble Health Fulton Inc. | Medicare Defined Swing Bed Unit | 10 S Hospital Dr, Fulton, MO 65251-2510 | 2020-08-26 |
| 1568936995 | Mosaic Medical Center - Maryville | Medicare Defined Swing Bed Unit | 2016 S Main St, Maryville, MO 64468-2655 | 2019-01-18 |
| 1861861726 | Southeast Health Center of Reynolds LLC | Medicare Defined Swing Bed Unit | 100 Highway 21 N, Ellington, MO 63638-9409 | 2015-09-22 |
| 1023487162 | Southeast Health Center of Ripley County | Medicare Defined Swing Bed Unit | 109 Plum St, Doniphan, MO 63935-1277 | 2015-09-18 |
| 1093194888 | Southeast Health Center of Ripley County | Medicare Defined Swing Bed Unit | 109 Plum St, Doniphan, MO 63935-1277 | 2015-05-26 |
| 1053707562 | Parkland Health Center - Weber Road | Medicare Defined Swing Bed Unit | 1212 Weber Rd, Farmington, MO 63640-3325 | 2015-04-10 |
| Find all providers with the same taxonomy | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
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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.