NPIMap

Organization Active NPI

Saint Francis Medical Center

Doing business as Kneibert Clinic

  • Rural Health Clinic/Center
  • Poplar Bluff, MO
National Provider Identifier
1356706378
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SAINT FRANCIS MEDICAL CENTER
Doing business as
Kneibert Clinic
Practice address
686 Lester St
Poplar Bluff, MO 63901
Phone
(573) 686-2411
Fax
(573) 686-8452
NPI assigned
Dec 17, 2015
Last updated
May 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2018

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

Authorized official

Name
Renee C Wilkerson
Title
Credentialing
Phone
(573) 331-5583

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Family Nurse Practitioner 363LF0000X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Psychologist 103T00000X NU
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

686 Lester St
Poplar Bluff, MO 63901

Mailing address

686 Lester St
Poplar Bluff, MO 63901-5025
Phone (573) 686-2411

Other names 1

  • Kneibert Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040107000140 MO Part B Supplier - Clinic/Group Practice 9931007929 Receives reassigned benefits from 615 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 37

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 37

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1356706378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 LESTER ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015025",
            "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": "SAINT FRANCIS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-17",
        "last_updated": "2018-05-15",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "573-331-5583"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kneibert Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kneibert 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 May 15, 2018; 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.