MISSOURI BAPTIST HOSPITAL OF SULLIVAN (NPI# 1962591958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962591958 |
| Entity Type | Organization |
| Organization Name | MISSOURI BAPTIST HOSPITAL OF SULLIVAN |
| Other Organization Name | RIVERSIDE MEDICAL CLINIC |
| Practice Address |
101 Progress Pkwy Sullivan MO 63080-2359 |
| Mailing Address |
670 Mason Ridge Center Dr Suite 300 Saint Louis MO 63141-8573 |
| Practice Telephone | 5734863555 |
| Practice Fax Number | 3149963610 |
| Mailing Telephone | 3149967644 |
| Mailing Fax Number | 3149967658 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2011-12-02 |
| Authorized Official Name | MR. AUGUSTO A NORONHA II (VICE PRESIDENT FINANCE AND CFO) |
| Authorized Official Telephone | 3149965118 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
355-24 | MO | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Riverside Medical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790953909 | Missouri Baptist Hospital of Sullivan | Obstetrics & Gynecology | 875 N Commercial Ave, Saint Clair, MO 63077-1118 | 2008-02-11 |
| 1396827408 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 102 Ozark Street, Suite B, Cuba, MO 65453-1664 | 2006-10-19 |
| 1487735445 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 510 West Main Street, Steelville, MO 65565 | 2006-10-18 |
| 1528676475 | Missouri Baptist Hospital of Sullivan | Clinical Medical Laboratory | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 | 2020-07-16 |
| 1891246617 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 751 Sappington Bridge Rd, Administration, Sullivan, MO 63080-2354 | 2016-10-17 |
| 1083165807 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 510 W Main St, Steelville, MO 65565 | 2016-10-17 |
| 1184174567 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 240 College St, Bourbon, MO 65441-8308 | 2016-10-10 |
| 1689124166 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 102 Ozark Dr Ste B, Cuba, MO 65453-1664 | 2016-10-10 |
| 1851841332 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 965 Mattox Dr, Sullivan, MO 63080-2365 | 2016-10-10 |
| 1770764193 | Missouri Baptist Hospital of Sullivan | Family Medicine | 510 West Main Street, Steelville, MO 65565 | 2007-11-15 |
| Street Address |
101 PROGRESS PKWY |
| City | SULLIVAN |
| State | MO |
| Zip Code | 63080-2359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003927773 | Felipe Eljaiek | Internal Medicine | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2006-08-31 |
| 1962027235 | Jennifer Keeler | Registered Nurse | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2020-06-12 |
| 1407470537 | Katie Dominique Sammon | Social Worker | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2020-06-04 |
| 1164054151 | Rochelle Marie Morgan | Counselor | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2020-02-07 |
| 1336783059 | Emily S Brendel | Counselor | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2019-11-06 |
| 1285275552 | Ijeoma Grace Elobuike | Dentist | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2019-10-08 |
| 1891336038 | Hannah Elizabeth Bledsoe | Registered Nurse | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2019-09-30 |
| 1952862732 | Jill Marie Kuenzel | Dental Hygienist | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2019-03-26 |
| 1285123968 | William James Mckenzie Iv | Counselor | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2018-05-08 |
| 1104328210 | Danielle Bealmear | Counselor | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2018-03-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669896650 | Lindsay Nicole Arnette | Physical Therapist | 940 Mattox Drive, Meramec Nursing Center, Sullivan, MO 63080 | 2014-02-11 |
| 1407099500 | Victorian Manor of Sullivan | Assisted Living Facility | 1250 East Springfield Rd, Sullivan, MO 63080 | 2009-04-20 |
| 1578729992 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 123 Progress Parkway, Sullivan, MO 63080 | 2008-08-05 |
| 1386826089 | Sellers Family Chiropractic PC | Chiropractor | 405 Wal Mart Drive, Sullivan, MO 63080 | 2007-12-04 |
| 1740495282 | Tasha Marie Rodriguez | Physical Therapist | 107 Congress Dr., Sullivan, MO 63080 | 2007-05-10 |
| 1033261649 | Clyde William Sellers II | Chiropractor | 405 Walmart Dr., Sullivan, MO 63080 | 2007-01-17 |
| 1407954209 | Sara Skidmore | Occupational Therapist | 2022 Phoenix Drive, Sullivan, MO 63080 | 2006-09-20 |
| 1083724116 | Sharon A Titter | Physical Therapist | 107 Progress Dr, Sullivan, MO 63080 | 2006-08-30 |
| 1437135571 | Thanh Duy Vo | Pediatrics | 486 N Church St, Sullivan, MO 63080 | 2005-12-20 |
| 1508849316 | Air Evac Ems Inc | Ambulance | 673 Sappington Bridge Rd, Sullivan, MO 63080 | 2005-11-25 |
| Find all providers in zip 63080 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811317977 | Mso Clinics, Inc. | Clinic/Center | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2014-04-16 |
| 1467716928 | Mercy Clinic East Communities | Clinic/Center | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2012-06-29 |
| 1649466038 | Patients First Health Care LLC | Clinic/Center | 101 Progress Pkwy, Sullivan, MO 63080-2359 | 2007-09-19 |
| 1235228222 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 965 Mattox Dr, Sullivan, MO 63080-2365 | 2006-10-11 |
| 1770502981 | Sullivan Family Practice, LLC | Clinic/Center | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2006-07-19 |
| 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.