Scheidler Rural Health Clinic, LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

SCHEIDLER RURAL HEALTH CLINIC, LLC

Practice address

301 South Byp
Kennett, MO 63857-3252

Phone

(573) 888-0900

Fax

(573) 888-9588

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Stefan Scheidler, M.D.NPI 1669525275

Title

Owner

Phone

57388808900

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO2 enrollments

Enrollment records 2

Rural health clinic certification: CCN 268960

Legal name

SCHEIDLER RURAL HEALTH CLINIC, LLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

May 10, 2007

Last certification

Oct 9, 2019

Ownership / control type

1A

Organization structure

LLCProprietary

Incorporated

Sep 11, 2006 in MO

Enrollment address

301 South Byp
Kennett, MO 63857-3252

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Stefan Scheidler, M.D.

  • Adult Medicine Physician
  • Kennett, MO
  • NPI 1669525275

  5% Or Greater Direct Ownership Interest, W-2 Managing Employee

  CMS ownership

Practitioners 2

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

• Stefan Scheidler, M.D.

  • Adult Medicine Physician
  • Kennett, MO
  • NPI 1669525275
  Medicare reassignment Care Compare group NPD Authorized official
• Heidi E Scheidler, PA

  • Medical Physician Assistant
  • Kennett, MO
  • NPI 1437285020
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1275686883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SOUTH BYP",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573252",
            "telephone_number": "573-888-0900",
            "fax_number": "573-888-9588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SOUTH BYP",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573252",
            "telephone_number": "573-888-0900",
            "fax_number": "573-888-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHEIDLER RURAL HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-10-27",
        "status": "A",
        "authorized_official_last_name": "SCHEIDLER",
        "authorized_official_first_name": "STEFAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "57388808900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "000015184",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Giovanni Santos
• Hugo Alberto Santos
• Mona Sawyer
• Joseph Masterson Scales, PHARMD
• Scheidler Rural Health Clinic
• Heidi E Scheidler, PA
• Stefan Scheidler, M.D.
• Hannah Schremp
• Peggy Lee Schuler, PA-C
• Tina Marie Scott-Barnes, A.A.

• Rural Health Clinic/Center in Kennett, MO
• Providers in Kennett, 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 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.