SOUTHEAST MISSOURI HOSPITAL PHYSICIANS LLC (NPI# 1780982215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780982215 |
Entity Type | Organization |
Organization Name | SOUTHEAST MISSOURI HOSPITAL PHYSICIANS LLC |
Other Organization Name | SOUTHEAST PRIMARY CARE - BROADWAY |
Practice Address |
1723 Broadway St Suite 205 Cape Girardeau MO 63701-4566 |
Practice Telephone | 5733317930 |
Mailing Telephone | 5733317930 |
Enumeration Date | 2011-03-08 |
Last Update Date | 2012-12-20 |
Authorized Official Name | HUBERT KING (VICE PRES CFO) |
Authorized Official Telephone | 5733344822 |
Is Organization Subpart | Y |
Parent Organization Name | SOUTHEAST MISSOURI HOSPITAL PHYSICIANS LLC |
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 |
---|---|
Southeast Primary Care - Broadway | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619245503 | Southeast Missouri Hospital Physicians LLC | Clinic/Center | 25 Doctors Park, Cape Girardeau, MO 63703-4927 | 2011-12-06 |
1699073122 | Southeast Missouri Hospital Physicians LLC | Clinic/Center | 817 S Mount Auburn Rd, Cape Girardeau, MO 63703-6383 | 2011-03-08 |
Street Address |
1723 BROADWAY ST SUITE 205 |
City | CAPE GIRARDEAU |
State | MO |
Zip Code | 63701-4566 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801893979 | Pairote Jaroonwanichkul | Internal Medicine | 1723 Broadway St, Suite 315, Cape Girardeau, MO 63701-4505 | 2005-07-05 |
1639611718 | Jared Michael Lewis | Physician Assistant | 1723 Broadway St, Suite 410, Cape Girardeau, MO 63701-4566 | 2016-11-07 |
1043768088 | Tyler Joshua Greenwood | Physician Assistant | 1723 Broadway St, Suite 410, Cape Girardeau, MO 63701-4566 | 2016-09-20 |
1275880429 | Jacob Louis Muckerman | Nurse Practitioner | 1723 Broadway St, Suite 410, Cape Girardeau, MO 63701-4566 | 2012-08-07 |
1003115536 | Gladys Grace Tiwonge Kamanga-sollo | Physical Medicine & Rehabilitation | 1723 Broadway St, Suite 410, Cape Girardeau, MO 63701-4566 | 2011-03-23 |
1679876767 | Magin Lea Chapman | Nurse Practitioner | 1723 Broadway St, Cape Girardeau, MO 63701-4566 | 2010-12-10 |
1821398678 | Andrew N Garner | Clinical Nurse Specialist | 1723 Broadway St, Cape Girardeau, MO 63701-4566 | 2010-10-27 |
1013222983 | Michele L Tanz | Nurse Practitioner | 1723 Broadway St, Suite 220, Cape Girardeau, MO 63701-4566 | 2010-08-16 |
1396066734 | Stephanie Lee Riley | Nurse Practitioner | 1723 Broadway St, Ste 410, Cape Girardeau, MO 63701-4566 | 2010-06-21 |
1407084890 | Jennifer Marie Lovegreen | Obstetrics & Gynecology | 1723 Broadway St, Suite 315, Cape Girardeau, MO 63701-4566 | 2009-06-24 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336748110 | Westbrook Dialysis, LLC | Clinic/Center | 140 West Drive, Cape Girardeau, MO 63701 | 2020-10-22 |
1972079580 | Savannah Laine Menard | Behavior Technician | 20 S. Sprigg St, Cape Girardeau, MO 63701 | 2018-10-22 |
1932690377 | Broadway Specialty, LLC | Pharmacy | 706 Broadway St, Cape Girardeau, MO 63701 | 2018-05-22 |
1356864649 | Terri L. Mccord | Pharmacist | 4170 Connor Dr, Cape Girardeau, MO 63701 | 2017-07-19 |
1013459312 | Christina Cossou | Nurse Practitioner | 2116 Megan Dr Ste 102, Cape Girardeau, MO 63701 | 2016-11-17 |
1124573365 | Ashley Sullivan | Massage Therapist | 3041 Melrose Ave, Cape Girardeau, MO 63701 | 2016-08-17 |
1225432172 | Axpm - Merkley, LLC | Dentist | 2116 Megan Dr., Suite 101, Cape Girardeau, MO 63701 | 2014-10-21 |
1639573397 | Marian Perez Hurt | Physical Therapist | 2001 N. Kingshighway, Fountainbleau Lodge, Cape Girardeau, MO 63701 | 2014-10-09 |
1891194213 | Deanna Abner | Case Manager/Care Coordinator | 20 South Sprigg, Cape Girardeau, MO 63701 | 2014-08-21 |
1831506880 | Kwadwo O Britwum | Behavioral Analyst | Morningstar Behavioral Associates, 338 W. Broadway Suite 301, Cape Girardeau, MO 63701 | 2014-07-22 |
Find all providers in zip 63701 |
Taxonomy Code | 261QR1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rural Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922122076 | Midtown Family Medical Center LLC | Clinic/Center | 24 N Sprigg St, Cape Girardeau, MO 63701-5526 | 2007-03-16 |
1619245503 | Southeast Missouri Hospital Physicians LLC | Clinic/Center | 25 Doctors Park, Cape Girardeau, MO 63703-4927 | 2011-12-06 |
1699073122 | Southeast Missouri Hospital Physicians LLC | Clinic/Center | 817 S Mount Auburn Rd, Cape Girardeau, MO 63703-6383 | 2011-03-08 |
1124142856 | Midtown Family Medical Center | Clinic/Center | 24 N Sprigg St, Cape Girardeau, MO 63701-5526 | 2007-03-19 |
1689725400 | River City Health Clinic, Inc | Clinic/Center | 224 N Frederick St, Cape Girardeau, MO 63701-5626 | 2007-01-16 |
1831174762 | Cape Girardeau County Health Department | Clinic/Center | 1121 Linden St, Lower Level, Cape Girardeau, MO 63703-7708 | 2005-12-14 |
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 | CAPE GIRARDEAU |
Zip Code | 63701 |
Please comment or provide details below to improve the information on SOUTHEAST MISSOURI HOSPITAL PHYSICIANS LLC.
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.