BURTON CREEK RURAL CLINIC, LLC (NPI# 1720075161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720075161 |
| Entity Type | Organization |
| Organization Name | BURTON CREEK RURAL CLINIC, LLC |
| Practice Address |
805 Kentucky Ave West Plains MO 65775 |
| Practice Telephone | 4172562111 |
| Practice Fax Number | 4172564858 |
| Mailing Telephone | 4172562111 |
| Mailing Fax Number | 4172564858 |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2010-08-03 |
| Authorized Official Name | MRS. SONJA LEA STAUFFER (ADMINISTRATOR) |
| Authorized Official Telephone | 4172562111 |
| Authorized Official Credential | MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 599022308 | 05 | |
| MO | 509022307 | 05 | |
| MEDICARE RR | DC9179 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003330713 | Burton Creek Rural Clinic, LLC | Family Medicine | 805 N Kentucky Ave, West Plains, MO 65775-2022 | 2017-08-03 |
| 1679879704 | Burton Creek Rural Clinic, LLC | Social Worker | 909 N Kentucky Ave, West Plains, MO 65775-2024 | 2011-02-08 |
| Street Address |
805 KENTUCKY AVE |
| City | WEST PLAINS |
| State | MO |
| Zip Code | 65775 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518961267 | Christine Helen Adcock | Nurse Practitioner | 805 Kentucky Ave, West Plains, MO 65775 | 2005-06-10 |
| 1487651931 | Jeffrey F Roylance | Family Medicine | 805 Kentucky Ave, West Plains, MO 65775 | 2005-06-30 |
| 1326044975 | Bryan Eck | Surgery | 805 Kentucky Ave, West Plains, MO 65775 | 2005-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598373359 | Ozarks Medical Center | Clinic/Center | Omc/zizzer Clinic, 1013 College Street, West Plains, MO 65775 | 2020-07-17 |
| 1962958678 | Fanny Ray | Massage Therapist | 1105 Independence Drive, West Plains, MO 65775 | 2016-09-01 |
| 1295184166 | Shaunda Faye Wolfe | Case Manager/Care Coordinator | 2301 K Hwy Apt. 2, West Plains, MO 65775 | 2016-06-10 |
| 1740694009 | Mary Loretta Rogganbuck | Counselor | 1211 Porter Wagoner #23, West Plains, MO 65775 | 2014-06-16 |
| 1548673858 | John Tollenaar | Physical Therapist | 1480 8th Streeet, West Plains, MO 65775 | 2014-06-04 |
| 1861818080 | Raymond Eugene Richardson | Case Manager/Care Coordinator | 1015 Lanton Road, West Plains, MO 65775 | 2014-03-12 |
| 1710309083 | Jared M Sadowitz | Physical Therapist | 1100 Kentucly Ave, West Plains, MO 65775 | 2014-01-06 |
| 1346682184 | Mark L. Dake Dds, Msd and David Sander Dmd, Mds | Dentist | 181 N. Kentucky, Suite 300, West Plains, MO 65775 | 2013-07-22 |
| 1427307024 | Anita M. Nelson | Behavioral Analyst | 8388 Pr 2731, West Plains, MO 65775 | 2012-08-29 |
| 1780959684 | Ozarks Medical Center | Pharmacy | 18 Parkway Center, West Plains, MO 65775 | 2012-03-12 |
| Find all providers in zip 65775 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952472391 | Ozarks Medical Center | Clinic/Center | 308 Davis Dr, West Plains, MO 65775-2279 | 2006-11-09 |
| 1750378220 | Doctors Urgent Care, PC | Clinic/Center | 1709 Gibson St, West Plains, MO 65775-1815 | 2005-09-30 |
| 1154838209 | Ozarks Medical Center | Clinic/Center | 312 N Kentucky Ave, West Plains, MO 65775 | 2018-01-10 |
| 1649306119 | Ozarks Medical Center | Clinic/Center | 181 N Kentucky Ave, Suite 100, West Plains, MO 65775-2089 | 2007-02-26 |
| 1629104104 | Ozarks Medical Center | Clinic/Center | 1211 Porter Wagoner Blvd, #23 Parkway Center, West Plains, MO 65775-1826 | 2007-02-26 |
| 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 | WEST PLAINS |
| Zip Code | 65775 |
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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.