Poplar Bluff Regional Medical Center LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

POPLAR BLUFF REGIONAL MEDICAL CENTER LLC

Practice address

101 S. Prairie
Bloomfield, MO 63825-0200

Phone

(573) 568-3838

NPI assigned

Jun 26, 2006

Organization subpart

No

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

Authorized official

Name

Paula Lalor

Title

Director/Delegated Official

Phone

(629) 215-3953

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bloomfield Medical Clinic Doing business as

Practitioners 2

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

• Regina Lewis, FNP

  • Family Nurse Practitioner
  • Cape Girardeau, MO
  • NPI 1902951429
  NPD (past)
• Dick J Newell, D.O.

  • Family Medicine Physician
  • Bloomfield, MO
  • NPI 1558395103
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1174550115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200",
            "address_2": "101 S. PRAIRE",
            "city": "BLOOMFIELD",
            "state": "MO",
            "postal_code": "638250200",
            "telephone_number": "573-568-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S. PRAIRIE",
            "city": "BLOOMFIELD",
            "state": "MO",
            "postal_code": "638250200",
            "telephone_number": "573-568-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPLAR BLUFF REGIONAL MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "629-215-3953"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "598557007",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bloomfield Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tara Gretchen Mouser, MCDCCCSLP
• Rachel Murdock, MA,SLP-CF
• Dick J Newell, D.O.
• Robin Denise Osborn, CSAC II
• Pedro Palomino, M.S.W.,L.C.S.W
• Poplar Bluff Regional Medical Center, LLC
• Prairie View Skilled Nursing LLC
• Christine Delores Rhodes, PHARMD
• V Susan L Shea
• Peter W Somers, PH.D. M.D.

• All providers in Bloomfield, MO
• Rural Health Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.