SOUTHEAST HEALTH CENTER OF STODDARD COUNTY LLC (NPI# 1679820286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679820286 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST HEALTH CENTER OF STODDARD COUNTY LLC |
| Other Organization Name | SOUTHEASTHEALTH BERNIE |
| Practice Address |
810 N Walnut St Bernie MO 63822-8901 |
| Practice Telephone | 5732935336 |
| Mailing Telephone | 5732935336 |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2014-04-16 |
| Authorized Official Name | SUE A WILLIAMS (ASSISTANT ADMINISTRATOR) |
| Authorized Official Telephone | 5736141951 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| SoutheastHEALTH Bernie | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639736457 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 800 Us Highway 61, New Madrid, MO 63869-1106 | 2019-05-28 |
| 1477997567 | Southeast Health Center of Stoddard County LLC | Emergency Medicine | 1200 N One Mile Road, Dexter, MO 63841-1000 | 2013-04-19 |
| 1265575385 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 1003 State Hwy 25 North, Bloomfield, MO 63825 | 2007-02-15 |
| 1679041040 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 522 Virginia St, Sikeston, MO 63801-5812 | 2018-11-05 |
| 1629111729 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 1300 N One Mile Rd, Dexter, MO 63841-1042 | 2007-02-15 |
| Street Address |
810 N WALNUT ST |
| City | BERNIE |
| State | MO |
| Zip Code | 63822-8901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972868719 | Cara M Dillinger | Nurse Practitioner | 810 N Walnut St, Bernie, MO 63822-8901 | 2012-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336282656 | Gideon Nursing Care Center Inc. | Homemaker | 400 Winchester Dr, Bernie, MO 63822 | 2007-02-15 |
| 1114069697 | Gideon Nursing Care Center | Homemaker | Winchester & Bowman, Bernie, MO 63822 | 2007-02-13 |
| 1487132890 | Winchester Nursing Center Inc | Skilled Nursing Facility | 400 Winchester Road, Bernie, MO 63822-0760 | 2018-07-30 |
| 1275675753 | Winchester Residential Care Inc | Assisted Living Facility | 400 Winchester, Bernie, MO 63822-0760 | 2007-02-13 |
| 1194981704 | Tammy Sharie Shepard | Counselor | 875 St. Hwy Vv, Kennett, MO 63822-6382 | 2008-08-03 |
| 1649607789 | Gideon Nursing Care Center Inc. | In Home Supportive Care | 404 Winchester Dr, Bernie, MO 63822-7500 | 2013-10-03 |
| 1194945154 | Southeast Missouri Health Network | Clinic/Center | 741 S Walnut St, Bernie, MO 63822-8900 | 2007-05-01 |
| 1972017416 | Katrina Leanne Miller | Nurse Practitioner | 741 S Walnut St, Bernie, MO 63822-8900 | 2017-11-20 |
| 1255696001 | Amanda Elaine Bader | Nurse Practitioner | 741 S Walnut St, Bernie, MO 63822-8900 | 2012-07-09 |
| 1669614822 | Tari D. Cupp | Speech-Language Pathologist | 605 Mulberry St, Bernie, MO 63822-9457 | 2009-04-01 |
| Find all providers in zip 63822 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| 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.