Active NPI
Burton Creek Rural Clinic, LLC
- Family Medicine Physician
- West Plains, MO
National Provider Identifier
1003330713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- BURTON CREEK RURAL CLINIC, LLC
- Practice address
- 805 N Kentucky Ave
West Plains, MO 65775-2022 - Phone
- (417) 256-2111
- Fax
- (417) 256-4858
- NPI assigned
- Aug 3, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Theresa Christine Gregg, MHA
- Title
- Ceo
- Phone
- (417) 256-2111
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
805 N Kentucky Ave
West Plains, MO 65775-2022
Mailing address
805 N Kentucky Ave
West Plains, MO 65775-2022
Phone (417) 256-2111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 599022308 | Medicaid | MO |
National Provider Directory
National Provider DirectoryLocations
805 N Kentucky Ave
Ste 1
West Plains, MO 65775
Phone (417) 256-2110
9104 State Highway 19
Winona, MO 65588
Phone (573) 325-4237
Interoperability endpoints
- https://api.platform.athenahealth.com/27794/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physician Assistant
- West Plains, MO
- NPI 1366413262
-
- Family Nurse Practitioner
- West Plains, MO
- NPI 1043575467
-
- Internal Medicine Physician
- West Plains, MO
- NPI 1609167402
-
- Family Nurse Practitioner
- Mountain Home, AR
- NPI 1881000321
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501718400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1779235200000",
"number": "1003330713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 N KENTUCKY AVE",
"city": "WEST PLAINS",
"state": "MO",
"postal_code": "657752022",
"telephone_number": "417-256-2111",
"fax_number": "417-256-4858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 N KENTUCKY AVE",
"city": "WEST PLAINS",
"state": "MO",
"postal_code": "657752022",
"telephone_number": "417-256-2111",
"fax_number": "417-256-4858"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BURTON CREEK RURAL CLINIC, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-08-03",
"last_updated": "2026-05-20",
"certification_date": "2026-05-20",
"status": "A",
"authorized_official_last_name": "GREGG",
"authorized_official_first_name": "THERESA",
"authorized_official_middle_name": "CHRISTINE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "417-256-2111",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "MHA"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "599022308",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Plains, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.