SSM AUDRAIN HEALTH CARE, INC. (NPI# 1871503466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871503466 |
| Entity Type | Organization |
| Organization Name | SSM AUDRAIN HEALTH CARE, INC. |
| Other Organization Name | SSM HEALTH MEDICAL GROUP - INTERNAL MEDICINE |
| Practice Address |
600 Medical Park Dr Mexico MO 65265-3724 |
| Mailing Address |
Po Box 478 Mexico MO 65265-0010 |
| Practice Telephone | 5735811040 |
| Practice Fax Number | 5735814949 |
| Mailing Telephone | 5735738127 |
| Mailing Fax Number | 5738527053 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-09-02 |
| Authorized Official Name | GARRICK ELLIOTT MUELLER (CFO) |
| Authorized Official Telephone | 4052807582 |
| Is Organization Subpart | Y |
| Parent Organization Name | SSM AUDRAIN HEALTH CARE, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 592463301 | 05 | |
| MO | 502463300 | 05 |
| Other Name | Type Code |
|---|---|
| SSM Health Medical Group - Internal Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801225982 | Ssm Audrain Health Care, Inc. | Clinic/Center | 201 S. Main, Auxvasse, MO 65231 | 2013-11-08 |
| 1255340246 | Ssm Audrain Health Care, Inc. | Family Medicine | 1223 Main Street, Perry, MO 63462 | 2006-08-07 |
| 1356712871 | Ssm Audrain Health Care, Inc. | Psychiatric Unit | 620 E Monroe St, Mexico, MO 65265-2919 | 2015-10-09 |
| 1336576008 | Ssm Audrain Health Care, Inc. | Obstetrics & Gynecology | 605 E Promenade St, Suite A, Mexico, MO 65265-2926 | 2013-09-26 |
| 1548520026 | Ssm Audrain Health Care, Inc. | Family Medicine | 221 N Main St, Paris, MO 65275-1328 | 2012-05-18 |
| 1336350214 | Ssm Audrain Health Care, Inc. | Family Medicine | 3626 S Clark St, Suite A, Mexico, MO 65265-4104 | 2007-05-24 |
| 1790838316 | Ssm Audrain Health Care, Inc. | Family Medicine | 3626 S Clark St, Mexico, MO 65265-4104 | 2007-01-18 |
| 1457469637 | Ssm Audrain Health Care, Inc. | Pediatrics | 3626 S Clark St Ste A, Mexico, MO 65265-4104 | 2006-08-28 |
| 1477563625 | Ssm Audrain Health Care, Inc. | Family Medicine | 625 E Summit St, Mexico, MO 65265-3294 | 2006-08-09 |
| 1467462010 | Ssm Audrain Health Care, Inc. | Family Medicine | 626 E Summit St Ste L, Mexico, MO 65265-3298 | 2006-08-08 |
| Street Address |
600 MEDICAL PARK DR |
| City | MEXICO |
| State | MO |
| Zip Code | 65265-3724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801899661 | Connie Ray Dunn | Nurse Practitioner | 600 Medical Park Dr, Mexico, MO 65265-3724 | 2005-05-24 |
| 1457500704 | Matthew Patrick Griffin | Internal Medicine | 600 Medical Park Dr, Mexico, MO 65265-3724 | 2008-09-11 |
| 1962698134 | Audrain Health Care, Inc. | Internal Medicine | 600 Medical Park Dr, Mexico, MO 65265-3724 | 2007-09-20 |
| 1245443548 | Manuel Le-yeng San | Family Medicine | 600 Medical Park Dr, Mexico, MO 65265-3724 | 2007-05-07 |
| 1588796254 | Mexico Internal Medicine, LLP | Internal Medicine | 600 Medical Park Dr, Mexico, MO 65265-3724 | 2007-03-09 |
| 1780639799 | Mexico Medical Specialists, L.c. | Internal Medicine | 600 Medical Park Dr, Mexico, MO 65265-3724 | 2006-05-24 |
| 1326023185 | Peggy Wanner-barjenbruch | Internal Medicine | 600 Medical Park Dr, Mexico, MO 65265-3724 | 2005-12-14 |
| 1952309890 | Sharon Parker Carmignani | Internal Medicine | 600 Medical Park Dr, Mexico, MO 65265-3724 | 2005-07-13 |
| 1134122989 | Shahid Waheed | Internal Medicine | 600 Medical Park Dr, Mexico, MO 65265-3724 | 2005-05-24 |
| 1841293610 | Mary Ellen Mullen | Internal Medicine | 600 Medical Park Dr, Mexico, MO 65265-3724 | 2005-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700448685 | Joanna Zidick Mcclarey | Specialist/Technologist | Rehabilitation Services, 711 E Jackson, Mexico, MO 65265 | 2019-07-01 |
| 1053858050 | Glenna Wilson | Social Worker | 2462 Southern Hls, Mexico, MO 65265 | 2017-01-27 |
| 1457601759 | Bruce Warren Garrett | Dentist | 626 Summit, Mexico, MO 65265 | 2012-09-13 |
| 1063775997 | Brandon Jay Glasgow | Physical Therapist | 2759 A S Clark, Mexico, MO 65265 | 2012-06-15 |
| 1407044548 | Missouri Central Physical Therapy, LLC | Specialist | 2759 A South Clark, Mexico, MO 65265 | 2007-10-12 |
| 1194925628 | Curators of The University of Missouri | Orthopaedic Surgery | 515 East Promenade, Mexico, MO 65265 | 2007-07-23 |
| 1740496199 | Scott Simmons | Family Medicine | 1000 Webster Street, Mexico, MO 65265 | 2007-05-15 |
| 1083741664 | Finck & Associates, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17079 Audrain County Road 929, Mexico, MO 65265 | 2007-02-28 |
| 1417005893 | Matthew Eugene Hart | Emergency Medicine | 620 E Monroe Street, Mexico, MO 65265 | 2007-01-08 |
| 1144392051 | Corrine M Floyd | Massage Therapist | 713 East Jackson, Mexico, MO 65265 | 2006-11-15 |
| Find all providers in zip 65265 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891088001 | Doc In A Box LLC | Clinic/Center | 1000 Webster Street, Suite 101, Mexico, MO 65265 | 2011-05-20 |
| 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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| 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.