Kneibert Clinic LLC
Organization Active NPI Rural Health Clinic/Center · Poplar Bluff, MO
NPI 1104804699 · NPPES record last updated Mar 22, 2012
Key facts
- NPI
- 1104804699
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- KNEIBERT CLINIC LLC
- Practice address
- 686 Lester St
Poplar Bluff, MO 63901 - Phone
- (573) 686-2411
- Fax
- (573) 686-8452
- NPI assigned
- Jan 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Robert E Christian
- Title
- Administrator
- Phone
- (573) 778-7210
Corporate family (same tax ID) 1
Practitioners 10
-
Rhonda K Adams, FNP
-
Rebecca A Fisher, MD
-
David Andrew Gayle, M.D.
-
Richard E Gayle, D.O.
-
Kimberly A Haley, FNP
-
Tina R McCorkell, FNP
-
Terry G Reese, MSN APRN FNP-BC
-
Peter W Somers, PH.D. M.D.
-
Shana Winchester, R.N., FNP-BC
-
Brian Paul Hauser, M.D.
National Provider Directory
- Tax ID family
- Kneibert Clinic LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Pediatrics Physician |
208000000X | |||
| Psychiatry Physician |
2084P0800X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
686 Lester St
Poplar Bluff, MO 63901
Mailing address
PO Box 220
Poplar Bluff, MO 63902
Phone (573) 686-2411
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107927002 | Medicaid | AR | |
| 500295407 | Medicaid | MO |
Other providers in Poplar Bluff, MO
- Janet I Kinworthy
- Kristy Kirby
- Donja Kirkland
- Daleena Kirkman
- Hannah Josephine Klick
- Kneibert Clinic LLC
- Kneibert Clinic LLC
- Kneibert Clinic LLC
- Kneibert Clinic LLC
- Kneibert Clinic LLC
All providers in Poplar Bluff, MO · Rural Health Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.