MISSOURI DELTA MEDICAL CENTER (NPI# 1568703130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568703130 |
| Entity Type | Organization |
| Organization Name | MISSOURI DELTA MEDICAL CENTER |
| Other Organization Name | PORTAGEVILLE COMMUNITY CARE CENTER |
| Practice Address |
204 E 3rd St Portageville MO 63873-1402 |
| Mailing Address |
1008 N Main St Sikeston MO 63801-5044 |
| Practice Telephone | 5733795467 |
| Practice Fax Number | 5733795671 |
| Mailing Telephone | 5734711600 |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2015-03-12 |
| Authorized Official Name | JASON SCHRUMPF (CEO/PRESIDENT) |
| Authorized Official Telephone | 5734727601 |
| Is Organization Subpart | Y |
| Parent Organization Name | MISSOURI DELTA MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Portageville Community Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427572007 | Missouri Delta Medical Center | Clinic/Center | 209 W Yoakum Ave, Chaffee, MO 63740-1138 | 2017-07-26 |
| 1093265159 | Missouri Delta Medical Center | General Acute Care Hospital | 2856 Vista Ridge Pl, Jackson, MO 63755-8105 | 2016-10-12 |
| 1013236421 | Missouri Delta Medical Center | Clinic/Center | 1013 North Main, Sikeston, MO 63801 | 2010-05-25 |
| 1871663583 | Missouri Delta Medical Center | General Acute Care Hospital | 1008 North Main, Sikeston, MO 63801-5044 | 2006-11-09 |
| 1790855401 | Missouri Delta Medical Center | General Acute Care Hospital | 1403 E Marshall St, Charleston, MO 63834-1446 | 2006-11-09 |
| 1609230507 | Missouri Delta Medical Center | Clinic/Center | 6468 State Highway 77, Benton, MO 63736-8237 | 2016-04-07 |
| 1821462284 | Missouri Delta Medical Center | Clinic/Center | 1008 N Main St, Sikeston, MO 63801-5044 | 2015-11-23 |
| 1043628704 | Missouri Delta Medical Center | Pharmacy | 1008 N Main St, Sikeston, MO 63801-5044 | 2014-07-25 |
| 1972944593 | Missouri Delta Medical Center | Family Medicine | 615 Main St, New Madrid, MO 63869-1513 | 2013-07-11 |
| 1215240965 | Missouri Delta Medical Center | Durable Medical Equipment & Medical Supplies | 1008 N Main St, Sikeston, MO 63801-5044 | 2010-07-23 |
| Street Address |
204 E 3RD ST |
| City | PORTAGEVILLE |
| State | MO |
| Zip Code | 63873-1402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053307975 | Andrew Ernest Painter | Family Medicine | 204 E 3rd St, Portageville, MO 63873-1402 | 2005-09-26 |
| 1619967106 | Douglas Stewart Fitzwater | Pediatrics | 204 E 3rd St, Portageville, MO 63873-1402 | 2005-10-26 |
| 1972593465 | Amy Kellams Stinnett | Nurse Practitioner | 204 E 3rd St, Portageville, MO 63873-1402 | 2005-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801158357 | Mindy Leigh French | Speech-Language Pathologist | 100 W 12th St, Portageville, MO 63873-1036 | 2012-06-11 |
| 1689299372 | Life Continues LLC | Community/Behavioral Health | 412 W 5th St, Portageville, MO 63873-1108 | 2020-06-09 |
| 1558574988 | Lee Kellams | Speech-Language Pathologist | 500 W 5th St, Portageville, MO 63873-1147 | 2007-05-08 |
| 1902910300 | Mary Samples | Speech-Language Pathologist | 904 King Ave, Portageville, MO 63873-1378 | 2006-08-19 |
| 1093858714 | Portageville School District | Local Education Agency (LEA) | 904 King Ave, Portageville, MO 63873-1378 | 2007-02-14 |
| 1871593905 | Lorna A Turnage | Clinic/Center | 203 E 3rd St, Portageville, MO 63873-1401 | 2005-07-29 |
| 1730622697 | Lorna Turnage | Family Medicine | 203 E 3rd St, Portageville, MO 63873-1401 | 2016-11-28 |
| 1841465671 | A Plus Family Clinic | Family Medicine | 203 E 3rd St, Portageville, MO 63873-1401 | 2008-04-23 |
| 1518968296 | Lorna Turnage | Family Medicine | 203 E 3rd St, Portageville, MO 63873-1401 | 2005-08-03 |
| 1265619522 | Dr. T. M. Swinger & Dr. D. V. Mckillip | Case Management | 219 King Ave, Portageville, MO 63873-1438 | 2008-01-29 |
| Find all providers in zip 63873 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699873372 | Pemiscot County Memorial Hospital | Clinic/Center | 314 E Main St, Portageville, MO 63873-1616 | 2006-09-20 |
| 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 | ||||
| City | PORTAGEVILLE |
| Zip Code | 63873 |
Please comment or provide details below to improve the information on MISSOURI DELTA MEDICAL CENTER.
| 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.