HAYTI MEDICAL CLINIC, INC (NPI# 1851373906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851373906 |
| Entity Type | Organization |
| Organization Name | HAYTI MEDICAL CLINIC, INC |
| Other Organization Name | EXTENDED HEALTH SYSTEMS MEDICAL CLINIC |
| Practice Address |
1502 Ward Ave Caruthersville MO 63830-2571 |
| Mailing Address |
Po Box 37 Hayti MO 63851-0037 |
| Practice Telephone | 5733334244 |
| Practice Fax Number | 5733334551 |
| Mailing Telephone | 5733592930 |
| Mailing Fax Number | 5733591304 |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GLENN HAYNES (CEO) |
| Authorized Official Telephone | 5733592930 |
| 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 |
|---|---|
| Extended Health Systems Medical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154303204 | Hayti Medical Clinic, Inc | Clinic/Center | 223 S 3rd St, Hayti, MO 63851-1617 | 2005-11-15 |
| 1982723375 | Hayti Medical Clinic, Inc | Clinic/Center | 223 S 3rd St, Hayti, MO 63851-1617 | 2007-03-28 |
| Street Address |
1502 WARD AVE |
| City | CARUTHERSVILLE |
| State | MO |
| Zip Code | 63830-2571 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841463551 | Pemiscot County Memorial Hospital | Clinic/Center | 1502 Ward Ave, Caruthersville, MO 63830-2571 | 2008-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689216400 | Jazmyne S Hall | Behavior Technician | 915 Highway 84, Caruthersville, MO 63830 | 2019-10-14 |
| 1134573017 | Nathan Straeter | Pharmacist | State Highway 84 West, Caruthersville, MO 63830 | 2016-04-18 |
| 1861805624 | Ashley Marie Ballard | Case Manager/Care Coordinator | 10 & Ward Suite C, Caruthersville, MO 63830 | 2014-06-09 |
| 1356764435 | Jena Payne | Case Manager/Care Coordinator | 10th Ward St, Caruthersville, MO 63830 | 2014-01-27 |
| 1619390705 | James Smith | Case Manager/Care Coordinator | 10th & Ward Suite B, Caruthersville, MO 63830 | 2014-01-27 |
| 1730501370 | Belinda Fields | Community Health Worker | 10th & Ward, C, Caruthersville, MO 63830 | 2014-01-16 |
| 1831387372 | T M Swinger & D V Mckillip, Ptr | Optometrist | 101 E. 10th St., Suite A, Caruthersville, MO 63830 | 2007-10-10 |
| 1437284635 | Terrence M Swinger | Optometrist | 101 E. Tenth St., Suite A, Caruthersville, MO 63830 | 2007-02-21 |
| 1114097581 | John D Gardner | Dentist | 1210 Ward Ave, Caruthersville, MO 63830 | 2006-11-09 |
| 1366512287 | Krilurk Chanvitayapongs | Pharmacist | 2709 South Ward, Caruthersville, MO 63830 | 2006-11-08 |
| Find all providers in zip 63830 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477870467 | Wt Regional Medical Associates | Clinic/Center | 108 W 15th Street, Caruthersville, MO 63830-2202 | 2010-04-29 |
| 1437251634 | Pemiscot County Memorial Hospital | Clinic/Center | 106 West 12th St, Caruthersville, MO 63830 | 2006-09-01 |
| 1467442566 | Douglas Fitzwater | Clinic/Center | 412 Ward Ave, Caruthersville, MO 63830-1451 | 2005-10-28 |
| 1841463551 | Pemiscot County Memorial Hospital | Clinic/Center | 1502 Ward Ave, Caruthersville, MO 63830-2571 | 2008-04-03 |
| 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 | CARUTHERSVILLE |
| Zip Code | 63830 |
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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.