STATE OF MISSOURI (NPI# 1861447526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861447526 |
| Entity Type | Organization |
| Organization Name | STATE OF MISSOURI |
| Other Organization Name | SOUTHEAST MO MENTAL HEALTH CENTER |
| Practice Address |
1010 W Columbia St Farmington MO 63640-2902 |
| Mailing Address |
1706 E Elm St Jefferson City MO 65101-4130 |
| Practice Telephone | 5732186792 |
| Practice Fax Number | 5732186703 |
| Mailing Telephone | 5737513398 |
| Mailing Fax Number | 5735264560 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2020-09-03 |
| Authorized Official Name | MOLLY JANE BOECKMANN (DIRECTOR OF ADMINISTRATIVE SERVICES) |
| Authorized Official Telephone | 5737514055 |
| Is Organization Subpart | Y |
| Parent Organization Name | STATE OF MISSOURI |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 050490200 | 05 |
| Other Name | Type Code |
|---|---|
| Southeast MO Mental Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437781499 | State of Missouri | Rehabilitation Counselor | 3418 Knipp Dr, Jefferson City, MO 65109-5701 | 2020-02-07 |
| 1275073280 | State of Missouri | General Practice | 1547 W Commerce Drive, Marshall, MO 65340-3907 | 2017-02-24 |
| 1528333085 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1000 N Colorado St, Nevada, MO 64772-1618 | 2012-03-16 |
| 1386843621 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15555 Little Blue Rd, Kansas City, MO 64139 | 2007-07-17 |
| 1922207679 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5410 Rinker Rd, Kansas City, MO 64129-2308 | 2007-07-13 |
| 1760681415 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1501 N River Blvd, Independence, MO 64050-1760 | 2007-07-13 |
| 1164630463 | State of Missouri | Intermediate Care Facility, Mentally Retarded | 11 Brady Cir, Overland, MO 63114-1110 | 2007-05-18 |
| 1548322605 | State of Missouri | Day Training, Developmentally Disabled Services | 1500 Vandiver Dr Ste 100, Columbia, MO 65202-3932 | 2006-12-15 |
| 1366503153 | State of Missouri | Day Training, Developmentally Disabled Services | 471 E Slater St, Marshall, MO 65340 | 2006-12-13 |
| 1427118033 | State of Missouri | Day Training, Developmentally Disabled Services | 522 Star St, Marshall, MO 65340 | 2006-12-12 |
| Street Address |
1010 W COLUMBIA ST |
| City | FARMINGTON |
| State | MO |
| Zip Code | 63640-2902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114909801 | Michael James Mccarver | Pharmacist | 1010 W Columbia St, Farmington, MO 63640-2902 | 2005-11-17 |
| 1437768025 | Taylor Cook | Dietitian, Registered | 1010 W Columbia St, Farmington, MO 63640-2902 | 2020-07-29 |
| 1265846307 | Jamie Barton | Pharmacist | 1010 W Columbia St, Farmington, MO 63640-2902 | 2014-06-17 |
| 1285050526 | Joshua Herwig | Nurse Practitioner | 1010 W Columbia St, Farmington, MO 63640-2902 | 2014-03-11 |
| 1447671052 | Jacquelyn Kathleen Rudolph | Pharmacist | 1010 W Columbia St, Farmington, MO 63640-2902 | 2013-12-27 |
| 1912206087 | Ismar Karadzic | Pharmacist | 1010 W Columbia St, Farmington, MO 63640-2902 | 2011-03-15 |
| 1902104177 | Mark Aaron Anderson | Pharmacist | 1010 W Columbia St, Farmington, MO 63640-2902 | 2011-03-11 |
| 1568779189 | Michael Martin Luther Krownapple | Psychologist | 1010 W Columbia St, Farmington, MO 63640-2902 | 2010-09-02 |
| 1629308002 | Gary L Thomas | Pharmacist | 1010 W Columbia St, Farmington, MO 63640-2902 | 2010-01-06 |
| 1245566611 | Thomas Stanley Finley I | Dentist | 1010 W Columbia St, Farmington, MO 63640-2902 | 2009-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
| 1619519089 | Stacey Nicole Gillette | Counselor | 17885 Hart Pinkston Rd, Farmington, MO 63640 | 2019-10-17 |
| 1346890696 | Christopher Ryan Massey | Social Worker | 607 Pine St., Farmington, MO 63640 | 2019-09-18 |
| 1457909376 | Clarice Ogden | Social Worker | 203 South Washington Street, Farmington, MO 63640 | 2019-09-04 |
| 1861979718 | Clint Thebeau | In Home Supportive Care | 1276 W Liberty St, Farmington, MO 63640 | 2018-07-24 |
| 1023500600 | Lynn Machelle Knox | Counselor | 219 W Columbia St, Farmington, MO 63640 | 2018-05-31 |
| 1235620576 | Kim Bazzell | Registered Nurse | 1565 Ste. Genevieve Ave., Farmington, MO 63640 | 2018-05-22 |
| 1164919742 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 774 Market St, Farmington, MO 63640 | 2018-04-18 |
| 1184127813 | Michelle Lynette Corvallis | Chiropractor | 17 South Franklin St., Farmington, MO 63640 | 2018-03-08 |
| 1992206213 | Farmington Vision Care LLC | Optometrist | 110 E Harrison St, Farmington, MO 63640 | 2018-02-22 |
| Find all providers in zip 63640 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558541755 | Marie E (melissa) Ring | Psychiatric Hospital | 1010 West Columbia, Farmington, MO 63640 | 2007-11-06 |
| 1215213764 | University of Connecticut Health Center | Psychiatric Hospital | 263 Farmington Ave, Farmington, CT 06030-1935 | 2011-10-28 |
| 1427105402 | Edward Charles Schuch Jr. | Psychiatric Hospital | 1010 W Columbia St, Suite 2026, Farmington, MO 63640-2902 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700485281 | Cape Girardeau Behavioral Health LLC | Psychiatric Hospital | 639 S Silver Springs Rd, Cape Girardeau, MO 63703-7539 | 2020-10-26 |
| 1760973044 | Centerpointe Hospital of Columbia, LLC | Psychiatric Hospital | 1201 International Drive, Columbia, MO 65202 | 2018-05-23 |
| 1790115939 | Nhc Reliant Psychiatric Services LLC | Psychiatric Hospital | 840 Passover Road, Osage Beach, MO 65065-2834 | 2013-11-26 |
| 1649518382 | Comc | Psychiatric Hospital | 5260 S Tanager Ave, Battlefield, MO 65619-9222 | 2013-01-30 |
| 1528340841 | St. Louis Regional Psychiatric Stabilization Center | Psychiatric Hospital | 5355 Delmar Boulevard, St. Louis, MO 63112-3146 | 2011-09-13 |
| 1750692638 | Global Psychiatric Associates Inc | Psychiatric Hospital | 16216 Baxter Rd Ste 323, Chesterfield, MO 63017-4778 | 2010-06-25 |
| 1346485257 | Western Missouri Mental Health | Psychiatric Hospital | 1000 E. 24th Street, Kansas City, MO 64108 | 2008-12-05 |
| 1033289897 | State of Missouri | Psychiatric Hospital | 1901 Pennsylvania Ave, Saint Louis, MO 63133-1325 | 2006-11-09 |
| 1497795892 | Midwest Division - Rpc, LLC | Psychiatric Hospital | 2323 E 63rd St, Kansas City, MO 64130-3462 | 2006-06-07 |
| 1104878792 | State of Missouri | Psychiatric Hospital | 600 E 5th St, Fulton, MO 65251-1753 | 2006-05-16 |
| Find all providers with the same taxonomy | ||||
| City | FARMINGTON |
| Zip Code | 63640 |
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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.