Southern Missouri Sleep Center, LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

SOUTHERN MISSOURI SLEEP CENTER, LLC

Practice address

2210 Barron Rd Ste 117
Poplar Bluff, MO 63901-1922

Phone

(573) 727-9661

Fax

(573) 727-9665

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Lynda Newman

Title

Director of Patient Care

Phone

(314) 645-5855

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Tax ID family

Southern Missouri Sleep Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Southern Missouri Sleep Center, LLC

  • Clinic/Center
  • Poplar Bluff, MO
  • NPI 1003853946
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen Nagy, M.D.

  • Internal Medicine Physician
  • Poplar Bluff, MO
  • NPI 1528012010
  NPD
• Matthew J Riffle, M.D.

  • Internal Medicine Physician
  • Poplar Bluff, MO
  • NPI 1770537367
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1124115894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 771933",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631771933",
            "telephone_number": "573-727-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD STE 117",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011922",
            "telephone_number": "573-727-9661",
            "fax_number": "573-727-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MISSOURI SLEEP CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT CARE",
        "authorized_official_telephone_number": "314-645-5855",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "201634",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "716394501",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeast Missouri Residential Services
• Southeast Rehabilitation, LLC
• Southeasthealth Hospital Holdings, LLC
• Southern Care and Comfort in Home Agency, LLC
• Southern Missouri Sleep Center, LLC
• Jody Beth Spain, APRN, FNP-BC
• Jennifer Spell
• Laronda Spence
• Tammy R Springer, BSW
• Lisa A Sprous, MS, LPC

• Physiological Laboratory in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Physiological Laboratory in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.