Active NPI
Kirksville Missouri Hosptial Company LLC
Doing business as Northeast Regional Medical Center
- Rehabilitation Hospital Unit
- Kirksville, MO
National Provider Identifier
1396718649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Hospital Unit
- License
- 462-4
- Legal business name
- KIRKSVILLE MISSOURI HOSPTIAL COMPANY LLC
- Doing business as
- Northeast Regional Medical Center
- Practice address
- 315 S Osteopathy
Kirksville, MO 63501-6401 - Phone
- (660) 785-1000
- NPI assigned
- Feb 8, 2006
- Last updated
- Nov 14, 2007
- Organization subpart
- Yes
- Parent organization
- KIRKSVILLE MISSOURI HOSPTIAL COMPANY LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Portacci
- Title
- Senior VP, Group Operations
- Phone
- (888) 373-9600
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Hospital Unit | 273Y00000X | 462-4 | MO | Primary |
Addresses
Primary practice location
315 S Osteopathy
Kirksville, MO 63501-6401
Mailing address
PO Box 503525
Saint Louis, MO 63150-3525
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10104 | Other | BCBS |
Other names 1
- Northeast Regional Medical Center
National Provider Directory
National Provider Directory- Part of
- Kirksville Missouri Co LLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1194998400000",
"number": "1396718649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 503525",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631503525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 S OSTEOPATHY",
"city": "KIRKSVILLE",
"state": "MO",
"postal_code": "635016401",
"telephone_number": "660-785-1000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KIRKSVILLE MISSOURI HOSPTIAL COMPANY LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "KIRKSVILLE MISSOURI HOSPTIAL COMPANY LLC",
"enumeration_date": "2006-02-08",
"last_updated": "2007-11-14",
"status": "A",
"authorized_official_last_name": "PORTACCI",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "SENIOR VP, GROUP OPERATIONS",
"authorized_official_telephone_number": "888-373-9600"
},
"taxonomies": [
{
"code": "273Y00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Unit",
"state": "MO",
"license": "462-4",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "10104",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Northeast Regional Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Kirksville, MO
- Kirksville Missouri Hospital Company LLC (Northeast Regional Medical Group)
- Kirksville Missouri Hospital Company LLC (Northeast Regional Medical Center)
- Kirksville Missouri Hospital Company LLC (Northeast Regional Medical Center)
- Kirksville Missouri Hospital Company, LLC (Northeast Regional Medical Center)
- Kirksville Missouri Hospital Company, LLC (Northeast Regional Medical Center)
- Kirksville Physical Therapy Services LLC
- Kirksville R-III Schools
- Kirksville Residential, LLC (Highland Crest)
- Kirksville Residential, LLC (Highland Crest Memory Care)
- Kirksville Specialty Clinic LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.