SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC (NPI# 1801990825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801990825 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC |
| Practice Address |
1200 N One Mile Rd Dexter MO 63841-1000 |
| Practice Telephone | 5736245566 |
| Mailing Telephone | 5736245566 |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2013-10-18 |
| Authorized Official Name | MR. PAULA E HARRIS (VICE PRESIDENT REGIONAL OPERAIONS) |
| Authorized Official Telephone | 5736141951 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 464-5 | MO | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 010722601 | 05 | |
| MO | 540722600 | 05 | |
| MO | BLUE CROSS/BLUE SHIELD | 54 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801891015 | Southeast Health Center of Stoddard County, LLC | Home Health | 1300 N One Mile Rd, Suite 7, Dexter, MO 63841-1042 | 2005-06-15 |
| 1780927871 | Southeast Health Center of Stoddard County, LLC | Clinic/Center | 2002 Kanell Blvd, Poplar Bluff, MO 63901-4045 | 2013-03-27 |
| 1316240096 | Southeast Health Center of Stoddard County, LLC | Clinic/Center | 500 N Douglass St, Malden, MO 63863-1506 | 2010-12-17 |
| 1457660045 | Southeast Health Center of Stoddard County, LLC | Clinic/Center | 2025 W Business Us Highway 60, Dexter, MO 63841-2879 | 2010-09-29 |
| 1386802023 | Southeast Health Center of Stoddard County, LLC | Medicare Defined Swing Bed Unit | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2008-05-29 |
| 1790828812 | Southeast Health Center of Stoddard County, LLC | Clinic/Center | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2007-02-15 |
| 1568524437 | Southeast Health Center of Stoddard County, LLC | Family Medicine | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2006-12-15 |
| 1710047618 | Southeast Health Center of Stoddard County, LLC | Clinic/Center | 1300 N One Mile Rd, Suite 2, Dexter, MO 63841-1042 | 2006-12-11 |
| Street Address |
1200 N ONE MILE RD |
| City | DEXTER |
| State | MO |
| Zip Code | 63841-1000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578557872 | Mina K Massey | Family Medicine | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2005-09-01 |
| 1255801247 | Kristin Suzanne Wheeler Guethle | Nurse Practitioner | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2018-12-03 |
| 1013493865 | Kerri Crawley | Nurse Practitioner | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2018-07-16 |
| 1578080214 | Stoddard Emergency Group, LLC | Physician Assistant | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2017-08-24 |
| 1851765614 | Leah Legrand | Nurse Practitioner | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2015-11-17 |
| 1841685989 | Angela Weiss | Nurse Practitioner | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2015-04-06 |
| 1356762132 | Meramec Emergency Physicians, LLP | Hospitalist | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2013-12-23 |
| 1407100944 | Tory L Sherman | Physician Assistant | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2012-11-06 |
| 1386802023 | Southeast Health Center of Stoddard County, LLC | Medicare Defined Swing Bed Unit | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2008-05-29 |
| 1396945663 | Cory W Blocker | Nurse Practitioner | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2007-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558941 | Christa Renee Mcbroom | Pharmacist | 2025 Business Hwy 60w, Dexter, MO 63841 | 2020-11-02 |
| 1306230107 | David Mulcahy | Pharmacist | 904 West Business Hwy 60, Dexter, MO 63841 | 2015-03-19 |
| 1285038935 | Clearwater In-home Care, Inc. | Technician | 1525 Business Highway 60, Suite C, Dexter, MO 63841 | 2014-10-09 |
| 1720404064 | William Simmons | Pharmacist | 904 W Business Highway 60, Dexter, MO 63841 | 2014-03-11 |
| 1134498736 | Susan Caroline Jones | Physical Therapist | 913 West Business Hwy 60, Dexter, MO 63841 | 2011-12-28 |
| 1427350594 | Dexter Hospital LLC | Family Medicine | 2025 W Bus Hwy 60, Dexter, MO 63841 | 2010-11-23 |
| 1992028112 | Hilda Fuwell's Residential Care LLC | Clinic/Center | 900 South One Mile Road, Dexter, MO 63841 | 2010-03-02 |
| 1508197047 | Super D Drugs Acquisition Co | Durable Medical Equipment & Medical Supplies | 907 West Business Hwy. 60, Dexter, MO 63841 | 2010-01-22 |
| 1215262183 | Ozark Wellness & Athletic Club | Physical Therapist | 1521 W Bus. Hwy. 60, Dexter, MO 63841 | 2009-10-12 |
| 1225268618 | Practice Tee, LLC | Family Medicine | 1523 W Business Hwy 60, Dexter, MO 63841 | 2009-07-20 |
| Find all providers in zip 63841 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396759361 | James Lawrence Kehoe IIi | General Acute Care Hospital | 15207 Colonial Ln, Dexter, MO 63841-8941 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295274256 | St. Lukes Health System | General Acute Care Hospital | 8101 N Lawndale Ave, Unit 2a, Kansas City, MO 64119-7808 | 2017-02-22 |
| 1093265159 | Missouri Delta Medical Center | General Acute Care Hospital | 2856 Vista Ridge Pl, Jackson, MO 63755-8105 | 2016-10-12 |
| 1285082040 | Jessica Teschner | General Acute Care Hospital | 3201 Ballard Mill Dr, Columbia, MO 65203-1875 | 2016-06-01 |
| 1912368002 | Emily Daniels | General Acute Care Hospital | 1737 Redbird Cv, Saint Louis, MO 63144-1610 | 2016-03-16 |
| 1225415417 | Parkland Veterinary Services, Inc. | General Acute Care Hospital | 615 E Karsch Blvd, Farmington, MO 63640-1225 | 2015-04-27 |
| 1841698164 | Mercy Clinic East Community | General Acute Care Hospital | 1021 Darwick Ct, Saint Louis, MO 63132-2909 | 2014-12-18 |
| 1831523695 | Saint Francis Medical Center | General Acute Care Hospital | 150 South Mount Auburn Road, Suite 342, Cape Girardeau, MO 63703 | 2013-08-29 |
| 1730528662 | Barnes Jewish Hospital | General Acute Care Hospital | 4512 Cleveland Ave, Apt 12, Saint Louis, MO 63110-3318 | 2013-06-25 |
| 1366796757 | Barnes Jewish Hospital | General Acute Care Hospital | 2180 Splendor Dr, Florissant, MO 63031-2640 | 2012-11-06 |
| 1952651341 | Faisal Alasmari | General Acute Care Hospital | 13928 Reflection Drive, Reflection Cove Apartments, Apt#235, Ballwin, MO 63021 | 2012-09-13 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, 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.