Children's Clinic

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

CHILDREN'S CLINIC

Practice address

2500 Lucy Lee Pkwy
Poplar Bluff, MO 63901-2436

Phone

(573) 686-2585

NPI assigned

Jun 24, 2008

Last updated

Jun 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rangsan Suvan, M.D.NPI 1467424416

Title

Owner/Physician

Phone

(573) 686-2585

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Rangsan Suvan, MD

  • Pediatrics Physician
  • Poplar Bluff, MO
  • NPI 1467424416
  NPD (past) Authorized official

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1609037381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 LUCY LEE PKWY",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012436",
            "telephone_number": "573-686-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 LUCY LEE PKWY",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012436",
            "telephone_number": "573-686-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "SUVAN",
        "authorized_official_first_name": "RANGSAN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "573-686-2585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS GROUP MEDICAID",
            "identifier": "131252002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Leigh Chatat, MSW
• Matthew Chatman, FNP
• Kaylee Nicole Cheek
• Imran Q Cheema, M.D.
• John Patrick Chervenak, M.R.C., C.R.C., L.P.
• Patricia Irene Chinburg
• Chiropractic Life Center Poplar Bluff PC
• Nichole Lynn Chism
• Shahid K Choudhary, M.D.
• Chelsea Danielle Chrisman

• Pediatrics Physician in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.