Poplar Bluff Pediatric Assoc LL

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

POPLAR BLUFF PEDIATRIC ASSOC LL

Practice address

2210 Barron Rd
Suite 120
Poplar Bluff, MO 63901-1908

Phone

(573) 785-2005

Fax

(573) 785-9444

NPI assigned

Feb 15, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Tiffany L Moss

Title

Office Manager

Phone

(573) 785-2005

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Claudia Karin Preuschoff, MD

  • Pediatrics Physician
  • Poplar Bluff, MO
  • NPI 1538246624

  General Practice

  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507161600000",
    "number": "1275676355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD",
            "address_2": "SUITE 120",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-785-2005",
            "fax_number": "573-785-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD",
            "address_2": "SUITE 120",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-785-2005",
            "fax_number": "573-785-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPLAR BLUFF PEDIATRIC ASSOC LL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2017-10-05",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "573-785-2005",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Poplar Bluff Emergency Physicians, LLC
• Poplar Bluff Hma Physician Management, LLC
• Poplar Bluff Medical Partners, LLC
• Poplar Bluff Neurology Center, PC
• Poplar Bluff No 1 Inc (The Manor)
• Poplar Bluff Pediatric Assoc LL
• Poplar Bluff Pharmacy LLC (John's Pharmacy Poplar Bluff)
• Poplar Bluff Pharmacy LLC (John's Pharmacy Highlands)
• Poplar Bluff Radiology Services Inc
• Poplar Bluff Regional Medical Center

• Rural Health Clinic/Center in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Rural Health Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; 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.