NPIMap

Organization Active NPI

Southeast Missouri Behavioral Health

  • Adult Mental Health Clinic/Center
  • Farmington, MO
National Provider Identifier
1013362078
Registry record updated Apr 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
1465 Issued in MO
Legal business name
SOUTHEAST MISSOURI BEHAVIORAL HEALTH
Practice address
5536 Hwy 32
Farmington, MO 63640-7357
Phone
(573) 756-5749
Fax
(573) 431-5205
NPI assigned
Apr 27, 2016
Last updated
Apr 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Barron E Pratte, PH.D.
Title
President
Phone
(573) 756-5749

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 1465 MO Primary

Addresses

Primary practice location

5536 Hwy 32
Farmington, MO 63640-7357

Mailing address

5536 Hwy 32
Farmington, MO 63640-7357
Phone (573) 756-5749

Other identifiers 1

IdentifierTypeStateIssuer
876173303MedicaidMO

Other names 1

  • Southeast Missouri Community Treatment Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Southeast Missouri Behavioral Health15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/semobh/r4/

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461715200000",
    "number": "1013362078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5536 HWY 32",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636407357",
            "telephone_number": "573-756-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5536 HWY 32",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636407357",
            "telephone_number": "573-756-5749",
            "fax_number": "573-431-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MISSOURI BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A",
        "authorized_official_last_name": "PRATTE",
        "authorized_official_first_name": "BARRON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-756-5749",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MO",
            "license": "1465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "876173303",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Missouri Community Treatment Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Farmington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.