NPIMap

Organization Active NPI

Kneibert Clinic LLC

Doing business as Kneibert Clinic Rural Health Clinic

  • Rural Health Clinic/Center
  • Poplar Bluff, MO
National Provider Identifier
1174501662
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
KNEIBERT CLINIC LLC
Doing business as
Kneibert Clinic Rural Health Clinic
Practice address
686 Lester St
Poplar Bluff, MO 63901
Phone
(573) 686-2411
Fax
(573) 686-8452
NPI assigned
Jan 4, 2006
Last updated
Oct 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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

Authorized official

Name
Robert E Christian
Title
Administrator
Phone
(573) 778-7210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

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 2

IdentifierTypeStateIssuer
149951729MedicaidAR
595929605MedicaidMO

Other names 1

  • Kneibert Clinic Rural Health Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kneibert Clinic LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224806400000",
    "number": "1174501662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "63902",
            "telephone_number": "573-686-2411",
            "fax_number": "573-686-8452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 LESTER ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "63901",
            "telephone_number": "573-686-2411",
            "fax_number": "573-686-8452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNEIBERT CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-04",
        "last_updated": "2008-10-24",
        "status": "A",
        "authorized_official_last_name": "CHRISTIAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-778-7210"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149951729",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "595929605",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kneibert Clinic Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2008; 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.