SOUTHEAST MISSOURI HOSPITAL PHYSICIANS LLC


Address: 1723 Broadway St, Suite 205, Cape Girardeau, MO 63701-4566
Phone: 5733317930

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR1300X Clinic/Center
Specialization: Rural Health
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Southeast Primary Care - Broadway Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 1723 BROADWAY ST
SUITE 205
City CAPE GIRARDEAU
State MO
Zip Code 63701-4566

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QR1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rural Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City CAPE GIRARDEAU
Zip Code 63701

Improve Information

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Dataset Information

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.

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