Organization Active NPI

Complete Healthcare LLC

  • Family Medicine Physician
  • Kennett, MO
National Provider Identifier
1447958962
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMPLETE HEALTHCARE LLC
Practice address
509 South Byp
Kennett, MO 63857-3248
Phone
(870) 243-4650
NPI assigned
Feb 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Authorized official

Name
Christopher Prather
Title
Compliance
Phone
(573) 559-2339

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

509 South Byp
Kennett, MO 63857-3248

Mailing address

PO Box 1246
Jonesboro, AR 72403-1246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230427000818 MO Part B Supplier - Clinic/Group Practice 4587029533 Receives reassigned benefits from 2 practitioners
Practice locations: Kennett, MO
O20240711001599 AR Part B Supplier - Clinic/Group Practice 4587029533 Receives reassigned benefits from 1 practitioner
Practice locations: Jonesboro, AR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1447958962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1246",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 SOUTH BYP",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573248",
            "telephone_number": "870-243-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-23",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "PRATHER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "COMPLIANCE",
        "authorized_official_telephone_number": "573-559-2339"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.